Content area
Full Text
World J Surg (2013) 37:21292133 DOI 10.1007/s00268-013-2093-7
Saucerization: A Modied Uncapitonnage Method of Surgery for Pulmonary Hydatidosis
Rahim Mahmodlou Nariman Sepehrvand
Mahya Nasiri
Published online: 9 May 2013 Socit Internationale de Chirurgie 2013
AbstractBackground There are contrary opinions regarding the surgical treatment of pulmonary hydatid cysts. We report our experience performing a modied version of uncapi-tonnage surgery, called saucerization, for treating pulmonary hydatid cysts.
Methods A total of 78 patients with pulmonary hydatid cysts were studied regarding their surgery outcome and the complication rate. The procedure used for cyst evacuation depended on whether the cyst had ruptured. If ruptured, cystotomy was done; otherwise, enucleation was preferred. To deal with the residual cavity in an uncapitonnage manner, we removed the thin margins of the pericyst and closed the bronchial openings at the cavity oor. All patients were followed up at least for 6 months.
Results The intensive care unit stay ranged from 1 to 9 days. Incomplete lung expansion (six patients) was the main postoperative complication followed by wound infection (four patients) and persistent air leak (C7 days) (one patient). There was one death. Dependence on mechanical ventilation and subsequent septic shock were also observed. The other patients exhibited no complications during the follow-up period.
Conclusions Our experience demonstrated a low complication rate associated with removing the thin margins of the residual cavity and changing the shape of it into a saucer. The results were satisfactory and comparable to the results of other studies on pulmonary hydatid cysts.
Introduction
Hydatid disease is still a major health problem in endemic regions such as the Middle East [13]. Humans are accidental intermediate hosts for the tapeworm Echinococcus [4]. The lung is the second most common organ affected by this disease [5, 6]. Single unilateral involvement is most common (7090 %) followed by multiple unilateral or bilateral lung involvement. The cysts are most often located in the right lower lobe of the lung [79]. The cysts grow rapidly in the lung because of the high negative pressure and the elasticity of pulmonary tissue.
Several treatment strategies have been suggested for treating uncomplicated or complicated pulmonary hydatid cysts. Although there are medical options, they are mainly reserved for inoperable cases (either because of dissemination of infection or there is a...