Capitonnage Results in Low Postoperative Morbidity in the Surgical Treatment of Pulmonary Echinococcosis

• Published in: The Annals of thoracic surgery Vol. 93; no. 3; pp. 962 - 966
• Main Authors: Yaldiz, Sadik, MD, Gursoy, Soner, MD, Ucvet, Ahmet, MD, Yaldiz, Demet, MD, Kaya, Seyda, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2012; Elsevier
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiology. Vascular system; Cardiothoracic Surgery; Child; Diseases caused by cestodes; Echinococcoses; Echinococcosis, Pulmonary - surgery; Female; Helminthic diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Parasitic diseases; Pneumology; Pneumonectomy - adverse effects; Pneumonectomy - methods; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Surgery; Young Adult; 11; Postoperative; Lung; Parasitosis; Helminthiasis; Cestode disease; Morbidity; Result; Infection; Treatment; Low; Surgery; Anesthesia; Circulatory system; Cardiology; Echinococciasis
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2011.11.011

Background The main surgical techniques in the treatment of pulmonary echinococcosis are cystotomy alone, cystotomy and capitonnage, enucleation, and pericystectomy. Controversy persists regarding the selection of surgical technique. We reviewed our experience to identify the impact of capitonnage on outcomes. Methods A single-institution retrospective analysis was made of the 308 consecutive patients with thoracic hydatid disease treated surgically during 17 years. Results The most common presenting symptoms were cough and chest pain. At presentation, 69 patients (22.4%) had complicated hydatid disease, cyst rupture into bronchus in 62 and into pleural cavity in 7. Bilateral involvement occurred in 37 patients (12.0%), simultaneous hepatic cysts in 36 (11.6%), and intrathoracic extrapulmonary involvement in 14 (4.5%). Surgery consisted of cystotomy with capitonnage in 271 patients (92.2%), cystotomy and closure of bronchial openings in 20 (6.8%), and lobectomy in 3 (1.0%). Hospital mortality was zero; postoperative complications developed in 21 patients (6.8%). Conclusions Cystotomy with capitonnage has a low complication rate. Pulmonary resection is best limited to patients with parenchymal destruction secondary to infection.