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Chirurgie 1. August 2011

One-stage surgical management for lung and liver hydatid diseases

BACKGROUND: Hydatid disease remains a serious health problem in Mediterranean areas. We reviewed the efficacy of a single-stage operation in coexisting cysts of lung and liver in patients. METHODS: Forty-one patients operated for the cysts located on the dome of the liver and right lung with one-stage surgical approach on between 1990 and 2010. There were 19 males (46%) and 22 females (54%) patients. The age range was 10–82 years, with a median age of 34 years. RESULTS: All patients had simultaneous operations for both organs via right thoracotomy and phrenotomy except one patient. Surgical techniques used in the lung were cystotomy and capitonnage, with wedge resection of the destroyed lung parenchyma in three (7.3%) and additional decortication in three (7.3%). Cystotomy was applied with membrane removal in the liver cysts. Postoperative complications were prolonged biliary drainage, empyema, prolonged air leak, pleural effusion in one case (2.4%) each, respectively. All patients managed successfully and discharged. No hospital mortality occurred. CONCLUSIONS: We propose that concomitant right pulmonary and liver dome hydatid cysts can be treated effectively and safely in a one-stage operation through a right posterolateral thoracotomy and phrenotomy.

Y. A. Karamustafaoglu, G. Reyhan, M. Kuzucuoglu, Y. Yoruk, European Surgery 4/2011

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