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Hepaticothoracic transdiaphragmatic echinococcosis.

J L Freixinet1, C A Mestres, E Cugat

  • 1Thoracic Surgery Service, Hospital Clínico y Provincial, University of Barcelona, Spain.

The Annals of Thoracic Surgery
|April 1, 1988
PubMed
Summary
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Surgical treatment for simultaneous liver and chest hydatid cysts is effective, with no postoperative deaths. Early surgical repair is indicated for hydatid disease complicated by transdiaphragmatic extension and pleural or pulmonary cysts.

Area of Science:

  • Medicine
  • Surgery
  • Parasitology

Background:

  • Hydatid disease, caused by Echinococcus granulosus, can affect multiple organs.
  • Simultaneous hydatid cysts in the liver and chest present a complex surgical challenge.

Purpose of the Study:

  • To evaluate the surgical management and outcomes of patients with simultaneous hepatic and thoracic hydatid cysts.
  • To highlight the importance of early surgical intervention in complex hydatid disease cases.

Main Methods:

  • Retrospective review of seven patients treated between 1970 and 1985.
  • Surgical approaches included thoracolaparotomy, thoracotomy, and transdiaphragmatic laparotomy.
  • Complete drainage or excision of hydatid cavities was performed, with intraoperative use of hydrogen peroxide to prevent spillage.

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Main Results:

  • No postoperative deaths were recorded in the seven patients.
  • Follow-up ranged from 6 months to 8 years, with two cases of relapsing hydatid disease.
  • Computed tomographic (CT) scanning is identified as the preferred imaging modality.

Conclusions:

  • Early surgical repair is recommended for liver hydatid disease with transdiaphragmatic extension and simultaneous pleural or pulmonary cysts.
  • Complete drainage and cyst excision are crucial for successful treatment.
  • Hydrogen peroxide instillation is a satisfactory method for controlling potential intraoperative spillage.