Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children

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...

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Main Authors: Ufuk Ateș, Ergun Ergün, Gülnur Göllü, Aydın Yağmurlu, A. Murat Çakmak, Hüseyin Dindar, Meltem Bingöl-Koloğlu
Format: Article
Language:English
Published: Galenos Publishing House 2017-04-01
Series:Ankara Üniversitesi Tıp Fakültesi Mecmuas
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Online Access: http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/thoracoscopic-cystostomy-of-pulmonary-hydatid-cyst/18324
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author Ufuk Ateș
Ergun Ergün
Gülnur Göllü
Aydın Yağmurlu
A. Murat Çakmak
Hüseyin Dindar
Meltem Bingöl-Koloğlu
author_facet Ufuk Ateș
Ergun Ergün
Gülnur Göllü
Aydın Yağmurlu
A. Murat Çakmak
Hüseyin Dindar
Meltem Bingöl-Koloğlu
author_sort Ufuk Ateș
collection DOAJ
description 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.
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series Ankara Üniversitesi Tıp Fakültesi Mecmuas
spelling doaj-art-367bcbacdc0d44d0ad942c43970125222025-08-20T03:55:07ZengGalenos Publishing HouseAnkara Üniversitesi Tıp Fakültesi Mecmuas1307-56081307-56082017-04-01701778210.1501/Tipfak_000000096813049054Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in ChildrenUfuk Ateș0Ergun Ergün1Gülnur Göllü2Aydın Yağmurlu3A. Murat Çakmak4Hüseyin Dindar5Meltem Bingöl-Koloğlu6 Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey Ankara University Medical Faculty, Department of Pediatric Surgery, Ankara, Turkey 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. http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/thoracoscopic-cystostomy-of-pulmonary-hydatid-cyst/18324 ChildrenHydatid CystThoracoscopy
spellingShingle Ufuk Ateș
Ergun Ergün
Gülnur Göllü
Aydın Yağmurlu
A. Murat Çakmak
Hüseyin Dindar
Meltem Bingöl-Koloğlu
Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
Ankara Üniversitesi Tıp Fakültesi Mecmuas
Children
Hydatid Cyst
Thoracoscopy
title Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
title_full Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
title_fullStr Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
title_full_unstemmed Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
title_short Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children
title_sort thoracoscopic cystostomy of pulmonary hydatid cyst in children
topic Children
Hydatid Cyst
Thoracoscopy
url http://ankaratipfakultesimecmuasi.net/archives/archive-detail/article-preview/thoracoscopic-cystostomy-of-pulmonary-hydatid-cyst/18324
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AT aydınyagmurlu thoracoscopiccystostomyofpulmonaryhydatidcystinchildren
AT amuratcakmak thoracoscopiccystostomyofpulmonaryhydatidcystinchildren
AT huseyindindar thoracoscopiccystostomyofpulmonaryhydatidcystinchildren
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