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Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children

Year 2017, Volume: 70 Issue: 1, 77 - 82, 21.04.2017
https://doi.org/10.1501/Tipfak_0000000968

Abstract

Aim: Echinococcosis is still an important health problem throughout the world, particularly in the
Mediterranean area. In humans, the lungs are the second most commonly affected sites. The disease may
affect children and its treatment may be challenging. In children, small hydatid cysts of the lungs respond
favorably to the medical treatment. Surgery is the standard option for the treatment of large and complicated
cysts. In current practice, thoracotomy and parenchyme-saving procedures such as cystostomy and
capitonnage remain the standard surgical approach for pulmonary hydatid cysts in children. However,
surgical experience with thoracoscopy is limited. The aim is to present the experience in thoracoscopic
management of pulmonary hydatid cysts in children.

Patients and Methods: Medical records of children who underwent thoracoscopic cystostomy of pulmonary
hydatid cysts between 2008- 2016 were reviewed. Surgical treatment was recommended for patients who
remained symptomatic on medical treatment and when the cyst size was larger than 6 cm in diameter.
Parenchyme-saving surgery was preferred which included cystostomy, removal of germinative membrane
and control of air leaks. Capitonnage was not preferred because of the risk of deterioration in lung capacity.


Results: Fifteen patients underwent 16 thoracoscopy procedures for pulmonary hydatid cysts. One of the patients
had bilateral complicated pulmonary hydatid cysts. There were conversions to mini-thoracotomy in 3 (20%)
procedures because the air leaks could not be controlled safely. The procedure was completed thoracoscopically in
12 patients. In thoracoscopically completed cases, prolonged air leak (over a week) occurred in 3 (25%) patients and
one of them underwent thoracotomy to control bronchopulmonary fistula. One of the patients underwent
laparoscopic cystostomy and capitonnage for associated liver hydatid cyst. There were no recurrences during 60
months of mean follow-up time and no problem was observed during the follow-up period.

Conclusion: Thoracoscopic management is recommended in children with uncomplicated hydatid cyst. In
complicated hydatid cysts, however, thoracoscopic wedge resection is recommended. If there is difficulty in
controlling bronchial openings, mini-thoracotomy could be considered. 

References

  • 1. Cevik M, Boleken ME, Kurkcuoglu IC, et al. Pulmonary hydatid disease is difficult recognized in children. Pediatric Surgery International 2014;30:737-741.
  • 2. Arroud M, Afifi MA, El Ghazi K, et al.Lung hydatic cysts in children: comparison study between giant and non-giant cysts. Pediatric Surgery International 2009;25:37-40.
  • 3. Ozyurtkan MO, Balci AE. Surgical treatment of intrathoracic hydatid disease:a 5-year experience in an endemic region. Surgery today 2010;40:31-37.
  • 4. Alpay L, Lacin T, Ocakcioglu I, et al. Is video-assisted thoracoscopic surgery adequate in treatment of pulmonary hydatidosis? The Annals of Thoracic Surgery 2015;100:258-262.
  • 5. Arinc S, Kosif A, Ertugrul M, et al.Evaluation of pulmonary hydatid cyst cases. International Journal of Surgery 2009;7:192-195.
  • 6. Turk F, Yuncu G, Karabulut N, et al. A single-center large-volume experience in the surgical management of hydatid disease of the lung with and without extrapulmonary involvement. World Journal of Surgery 2013;37:2306-2312.
  • 7. Parelkar SV, Gupta RK, Shah H, et al.Experience with video-assisted thoracoscopic removal of pulmonary hydatid cysts in children. Journal of Pediatric Surgery 2009;44:836-841.
  • 8. Kanat F, Turk E, Aribas OK. Comparison of pulmonary hydatid cysts in children and adults. ANZ Journal of Surgery 2004;74:885-889.
  • 9. Aydogdu B, Sander S, Demirali O, et al.Treatment of spontaneous rupture of lung hydatid cysts into a bronchus in children. Journal of Pediatric Surgery 2015;50:1481-1483.
  • 10. Kurkcuoglu I, Eroglu A, Karaoglanoglu N, et al. Surgical approach of pulmonary hydatidosis in childhood. International Journal of Clinical Practice 2005;59:168-172.
  • 11. Tullu MS, Lahiri KR, Kumar S, et al.Minimal access therapy in pediatric pulmonary hydatid cysts. Pediatric pulmonology 2005;40:92-95.
  • 12. Mehta KD, Gundappa R, Contractor R, et al. Comparative evaluation of thoracoscopy versus thoracotomy in the management of lung hydatid disease.World Journal of Surgery 2010;34:1828-1831
Year 2017, Volume: 70 Issue: 1, 77 - 82, 21.04.2017
https://doi.org/10.1501/Tipfak_0000000968

Abstract

References

  • 1. Cevik M, Boleken ME, Kurkcuoglu IC, et al. Pulmonary hydatid disease is difficult recognized in children. Pediatric Surgery International 2014;30:737-741.
  • 2. Arroud M, Afifi MA, El Ghazi K, et al.Lung hydatic cysts in children: comparison study between giant and non-giant cysts. Pediatric Surgery International 2009;25:37-40.
  • 3. Ozyurtkan MO, Balci AE. Surgical treatment of intrathoracic hydatid disease:a 5-year experience in an endemic region. Surgery today 2010;40:31-37.
  • 4. Alpay L, Lacin T, Ocakcioglu I, et al. Is video-assisted thoracoscopic surgery adequate in treatment of pulmonary hydatidosis? The Annals of Thoracic Surgery 2015;100:258-262.
  • 5. Arinc S, Kosif A, Ertugrul M, et al.Evaluation of pulmonary hydatid cyst cases. International Journal of Surgery 2009;7:192-195.
  • 6. Turk F, Yuncu G, Karabulut N, et al. A single-center large-volume experience in the surgical management of hydatid disease of the lung with and without extrapulmonary involvement. World Journal of Surgery 2013;37:2306-2312.
  • 7. Parelkar SV, Gupta RK, Shah H, et al.Experience with video-assisted thoracoscopic removal of pulmonary hydatid cysts in children. Journal of Pediatric Surgery 2009;44:836-841.
  • 8. Kanat F, Turk E, Aribas OK. Comparison of pulmonary hydatid cysts in children and adults. ANZ Journal of Surgery 2004;74:885-889.
  • 9. Aydogdu B, Sander S, Demirali O, et al.Treatment of spontaneous rupture of lung hydatid cysts into a bronchus in children. Journal of Pediatric Surgery 2015;50:1481-1483.
  • 10. Kurkcuoglu I, Eroglu A, Karaoglanoglu N, et al. Surgical approach of pulmonary hydatidosis in childhood. International Journal of Clinical Practice 2005;59:168-172.
  • 11. Tullu MS, Lahiri KR, Kumar S, et al.Minimal access therapy in pediatric pulmonary hydatid cysts. Pediatric pulmonology 2005;40:92-95.
  • 12. Mehta KD, Gundappa R, Contractor R, et al. Comparative evaluation of thoracoscopy versus thoracotomy in the management of lung hydatid disease.World Journal of Surgery 2010;34:1828-1831
There are 12 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Gülnur Göllü

Publication Date April 21, 2017
Published in Issue Year 2017 Volume: 70 Issue: 1

Cite

APA Göllü, G. (2017). Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 70(1), 77-82. https://doi.org/10.1501/Tipfak_0000000968
AMA Göllü G. Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children. Ankara Üniversitesi Tıp Fakültesi Mecmuası. April 2017;70(1):77-82. doi:10.1501/Tipfak_0000000968
Chicago Göllü, Gülnur. “Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70, no. 1 (April 2017): 77-82. https://doi.org/10.1501/Tipfak_0000000968.
EndNote Göllü G (April 1, 2017) Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70 1 77–82.
IEEE G. Göllü, “Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 1, pp. 77–82, 2017, doi: 10.1501/Tipfak_0000000968.
ISNAD Göllü, Gülnur. “Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70/1 (April 2017), 77-82. https://doi.org/10.1501/Tipfak_0000000968.
JAMA Göllü G. Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70:77–82.
MLA Göllü, Gülnur. “Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 1, 2017, pp. 77-82, doi:10.1501/Tipfak_0000000968.
Vancouver Göllü G. Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70(1):77-82.