روش هاي جراحي و عوارض بعد از عمل در كيست هاي هيداتيد ريه ژانت و غير ژانت

Surgical Procedures and Postoperative Complications in Patients with Giant and Non-giant Pulmonary Hydatid Cysts

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺑﻪ ﻋﻠﺖ ﺍﻳﻦ ﮐﻪ ﺩﺭ ﻣﻄﺎﻟﻌﺎﺕ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺩﺭﻣﺎﻥ ﺟﺮﺍﺣﻲ ﮐﻴﺴﺖ ﻫﻴﺪﺍﺗﻴﺪ ﺭﻳﻪ ﮊﺍﻧﺖ ﺑﺤﺚ ﻭ ﺟﺪﻝ ﻭﺟﻮﺩ ﺩﺍﺭﺩ، ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮ ﺍﺳﺎﺱ ﻣﻘﺎﻳﺴﻪ ﺭﻭﺵﻫﺎﻱ ﺟﺮﺍﺣﻲ ﻋﻮﺍﺭﺽ ﺑﻌﺪ ﺍﺯ ﻋﻤﻞ ﮐﻴﺴﺖﻫﺎﻱ ﻫﻴﺪﺍﺗﻴﺪ ﺭﻳﻪ ﮊﺍﻧﺖ ﻭ ﻏﻴﺮ ﮊﺍﻧﺖ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ ﺍﺳﺖ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﮔﺬﺷﺘﻪﻧﮕﺮ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﮐﻴﺴﺖ ﻫﻴﺪﺍﺗﻴﺪ ﺭﻳﻪ ﺩﺭ ﺩﻭ ﮔﺮﻭﻩ ﮊﺍﻧﺖ ﻭ ﻏﻴﺮ ﮊﺍﻧﺖ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ ﺍﺳﺖ. ﺍﻧﺪﺍﺯﻩ ﮐﻴﺴﺖ ﮊﺍﻧﺖ ﺑﻪ ﺑﻴﺸﺘﺮ ﺍﺯ 10 ﺳﺎﻧﺘﻴﻤﺘﺮ ﺍﻃﻼﻕ ﻣﻲﺷﻮﺩ. ﺑﻴﻤﺎﺭﺍﻥ ﺑﻪ ﺭﻭﺵﻫﺎﻱ ﺟﺮﺍﺣﻲ ﺣﻔﻆ ﭘﺎﺭﺍﻧﺸﻴﻢ ﺭﻳﻪ ﺑﺎ ﻭ ﺑﺪﻭﻥ ﮐﺎﭘﻴﺘﻮﻧﺎﮋ ﺳﮕﻤﻨﮑﺘﻮﻣﻲ ﻭ ﻟﻮﺑﮑﺘﻮﻣﻲ ﺩﺭﻣﺎﻥ ﺟﺮﺍﺣﻲ ﺷﺪﻩﺍﻧﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺍﺯ 612 ﺑﻴﻤﺎﺭ، 59 ﺑﻴﻤﺎﺭ ﺩﺭ ﮔﺮﻭﻩ ﮊﺍﻧﺖ ﻭ 553 ﺑﻴﻤﺎﺭ )90/4 ﺩﺭ ﮔﺮﻭﻩ ﻏﻴﺮ ﮊﺍﻧﺖ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﻋﻼﺋﻢ ﺑﺎﻟﻴﻨﻲ ﺷﺎﻳﻊ ﮔﺮﻭﻩ ﮊﺍﻧﺖ ﺳﺮﻓﻪ ﻭ ﺩﻳﺴﭙﻨﻪ )71/2 ﺑﻮﺩﻩ ﺍﺳﺖ. ﻋﻼﺋﻢ ﺳﻴﺴﺘﻤﻴﮏ ﻧﻴﺰ ﺩﺭ ﺑﻴﻤﺎﺭﺍﻥ ﻣﺒﺘﻼ ﺑﻪ ﮐﻴﺴﺖ ﻫﻴﺪﺍﺗﻴﺪ ﭘﺎﺭﻩ ﺷﺪﻩ ﺩﺭ ﮔﺮﻭﻩ ﮊﺍﻧﺖ ﺩﻳﺪﻩ ﺷﺪﻧﺪ )0/001

Introduction & Objective: There is a challenge over the treatment of giant pulmonary hydatid cysts. Therefore, we aimed at comparing the surgical procedures and postoperative complications between patients with giant and non-giant hydatid cysts. Materials & Methods: In a retrospective clinical study, patients operated for hydatid lung cysts were divided into giant pulmonary hydatid cysts (size >10 cm) and non-giant hydatid cysts groups. Patients were treated surgically using lung preservation (capitonnage, uncapitonnage and segmentectomy) and lobectomy procedures. Results: A total of 612 patients, 59 (9.6%) in the giant and 553 (90.4%) in the non-giant pulmonary hydatid cysts, were recruited. The most common symptoms in the giant group were cough 59 (100%) and dyspnea 42 (71.2%). These symptoms along with the systemic symptoms and ruptured hydatid cysts were more observed in the giant group (P<0.001). The lung preservation procedures and cyst delivery were performed in the non-giant group (P<0.001), while lobectomy, needle aspiration and bronchial opening closure procedures were applied to the giant group (P<0.05). The postoperative pulmonary complications, excluding empyema and anaphylaxis, were more observed in the non-giant group (P<0.001). Conclusions: The patients undergoing the surgery of giant pulmonary hydatid cysts, using lobectomy rather than lung preserving procedures, experience lesser postoperative pulmonary complications and total length of hospitalization. However, pulmonary preservation methods are recommended in the surgery of Nongiant lung hydatid cysts treatment.