Intact and Perforated Pulmonary Hydatid Cyst: A Comparative Study from Damascus, Syria

Background@#Hydatidosis is a major health problem around the world, especially in the Mediterranean region. Cysts can break open or develop secondary bacterial infections, alter ing the clinical presentation. @*Methods@#Patients who underwent hydatid cyst surgery at Al-Mouassat University Hospital in Damascus, Syria between January 2006 and December 2017 were evaluated. Cases involving isolated hepatic cysts were excluded. The patients were divided into those with perforated hydatid cysts (group 1) and those with intact hydatid cysts (group 2). @*Results@#This study included 224 cases: 113 in group 1 (50.4%) and 111 in group 2 (49.6%).The median chest tube duration, hospitalization time, and postoperative complication rate were higher in group 1 than in group 2 (p=0.003, p=0.002, and p=0.006, respectively). In both groups, the most common symptom was cough (present in 178 patients in total [79.5%]), while chest pain (121 patients [54%]) and dyspnea (113 patients [50.4%]) were also common. Cough, hemoptysis, fever, and expectoration of cystic contents were significantly more frequent in group 1 than in group 2 (p<0.001). @*Conclusion@#The early discovery and treatment of intact pulmonary hydatid cysts reduced the hospitalization time, chest tube duration, and postoperative complication rate.Relative to intact cysts, perforated cysts are more complex and are associated with more expensive and time-consuming surgical treatment.

Traumatic tracheoesophageal fistula [TTEF]: case report

Acquired tracheoesophageal fistulas [TEFs] occur secondary to malignant disease [esophageal or bronchial], infection or trauma. Postintubation TEFs uncommonly occurs following prolonged ventilation with an endotracheal or tracheostomy tube. We report a 23 year old woman who, following of 2 weeks mechanical ventilation, presented with recurrent aspiration pneumonia and dyspnea directly post extubation. Bronchoscopy showed mild tracheal stenosis and 3 cm long traheoesophageal fistula. A4 cm tracheal resection and reconstruction with closing the esophageal fistula was performed successfully

[Results of management for coxisting pulmonary and extrapulmonary hydatid cysts]

Surgery is the treatment of choice in hydatid cysts. The surgical procedure depends on the location, number, and complications of the cysts, especially if coexisting pulmonary and extrapulmonary cysts, especially if coexisting pulmonary and extrapulmonary cysts are present. This study aims to describe the approach of surgical treatment, the outcomes, the complications, and the period of hospitalization in isolated unilateral pulmonary hydatid cyst and in bilateral pulmonary or extrapulmonary cysts in our department. This prospective study was done between January 1993 and December 2002. It included 236 surgical procedures performed on 206 patients [83 males, 123 females], aged between 4 and 69 years, with a mean age of 29.4 years. Of the 206 patients: 146 patients [70%] had isolated unilateral lung cysts; 60 patients [29%] had coexisting pulmonary and extrapulmonary cysts. A surgical procedure was done in all patients for isolated pulmonary hydatid cysts [n=146]. In 33 patients with coexisting pulmonary and extrapulmonary hydatid cysts a one-step procedure was done. A two step operation was done in 24 patients, and a three step operation was done in 3 patients

[Results of the management of pulmonary hydatid cysts]

Background: The surgical procedures of the hydatid cysts can be performed in relation to the location, the number of the cysts and their complications

Objective: The aim of this study is to determine the prevalence of pulmonary hdatid cysts, determine the best approach of surgical treatment, and determine the outcomes of hdatid disease in, isolated or coexisting pulmonary or extrapulmonary hydatidosis

Patients and Methods: The study was conducted at the Department of Thoracic Surgery at Damascus University, between January 1993 and December 2002, on 206 patients aged between 4 and 69 years with a mean age of 29.4 years, [83 male, 123 female] Of 206 patients: 146 patients [70.8 %] had isolated unilateral lung cysts, 60 patients [29.2%] had coexisting pulmonary and extrapulmonary cysts. The operations were performed on one-, two-, or three - stage surgical procedures

Results: No recurrence neither mortality were recorded. Postoperative complications occurred in 17 patients [8.3%]. There was no significant difference in complications between isolated or coexisting pulmonary and extrapulmonary locations. However, Postoperative complications were much higher in patients who had complicated cysts or polycystic disease

Conclusion: The lung-preserving surgical interventions are the treatment of choice for pulmonary hydatid disease. In patients with coexisting pulmonary and extrapulmonary cysts the one- stage approach is preferred. Median sternotomy with or without laparotomy is an excellent approach. Postoperative complications are low