Single-centre experience in treatment of multiple-site hydatid disease in a tertiary care centre of Eastern India
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Single-stage surgery for multiple-site hydatid cysts especially for the lung and liver is a less performed approach.
The aim of the study is to assess the feasibility of this approach in terms of outcome.
We studied 42 patients with multiple-site hydatid cysts over a period of 36 months admitted or referred to the department of CTVS of a tertiary-level hospital of Eastern India.
Maximum numbers of cases were found in the age group of 11–20 years comprising 35.71% of the patient population with a female preponderance (18 versus 24). Chest pain was the commonest presenting feature (66.66%) followed by cough (52.38%), haemoptysis and dyspnoea 33.33% respectively. Eosinophilia was observed in four patients (9.52%). Twenty-two patients had simultaneous occurrence of pulmonary and hepatic hydatid disease (52.38%). Fourteen patients had only pulmonary involvement (33.33%). Chest wall (including the parietal pleura) was involved in six patients (14.28%). 23.03% patients presented with complicated cysts in the form of rupture into the pleura (19.35%) or the peritoneum (9.68%). Eighteen patients (42.86%) were operated via posterolateral thoracotomy and 18 (42.86%) were operated via thoracotomy with phrenotomy. Twenty-four patients (57.14%) underwent cyst excision by Barrett’s technique. 59.09% patients underwent cystostomy for hepatic hydatids and five underwent omental packing (22.72%). Prolonged air leak was the commonest complication (35.71%). The mean operative time for thoracotomy was 136.87 min (~ 140 min) and 145 min for thoracotomy with phrenotomy. Only five patients (11.9%) required a prolonged intensive –treatment unit (ITU) stay of > 2 days and four had prolonged hospital stay > 15 days (1 of bronchopleural fistula, 1 of anaphylactic shock and 1 of bilateral lung cyst excision with postoperative lobar collapse).
Single-stage surgery is a viable option for multiple- and multi-site hydatids.
KeywordsMultiple hydatid cysts Barrett’s technique Thoracotomy
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. A copy of approval from the ethical committee can be made available for review by the Editor-in-Chief of this journal.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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