Capitonnage method selection in pulmonary hydatidosis with purse-string or interrupted suture.

BACKGROUND: Disfigurements in the lung parenchyma due to capitonnage methods may lead to long-term atelectasis. The aim of the present study was to examine whether there are any complication differences between the capitonnage applied via interrupted suture or purse-string suture. METHOD: Of the total of 120 cases that underwent hydatid cyst surgery during 2007 and 2020, those that were subject to capitonnage were included in the study. The preoperative and postoperative findings were analyzed for 76 cases subject to purse-string capitonnage (Group I) and 24 interrupted capitonnage (Group II). RESULTS: While the number of cases with complication in Group I was 16 (21.1%), there were only 2 (8.3%) complications in Group II; however, the difference was not statistically significant (P = 0.23). Bronchopleural fistula (n = 1) and prolonged air leak (n = 2) were observed in Group I, there was no bronchopleural fistula or prolonged air leak in Group II. Atelectasis was the most frequently observed complication observed in 12 (15.8%) cases in Group I and 2 (8.3%) cases in Group II (P = 0.53). The duration of hospitalization was lower for the patients in Group II. The number of days was 7.3 ± 2.7 for Group I and 5.3 ± 2.1 for Group II (P < 0.01). CONCLUSION: This study is the first to compare whether there are any complication differences between the capitonnage methods via interrupted suture or purse-string suture. The results of the study put forth that the duration of hospitalization is lower in the interrupted capitonnage group. Parenchymal anatomy may be preserved better in interrupted capitonnage method.

Pulmonary langerhans cell histiocytosis case with diabetes insipidus and tuberculosis.

A 19-year-old male patient was observed due to having central diabetes insipidus (DI) for five years. He had a history of smoking 5-10 cigarettes a day for two years, but stopped smoking from the last month. The computerized tomography revealed thin-walled cystic lesions in different sizes more dominantly in the upper lobes and consolidated areas in the left upper and lower lobes. The wedge resection from the right lower lobe revealed pulmonary langerhans cell histiocytosis. Follow-up acid-fast bacteria (AFB) examinations revealed (+++) and antituberculous treatment was started. On the 40th day of the anti-tuberculosis treatment, the patient applied once again due to fever and chest pain. Although infiltrations persisted in the left upper and middle zones in the postero-anterior lung rontgenogram, right-sided pneumothorax was detected. The case is considered tuberculosis and the patient continued to receive anti-TB treatment under the close supervision.

Spontaneous hemopneumothorax: is conservative treatment enough?

PURPOSE: Spontaneous hemopneumothorax is a rare disorder, occurring in 1% to 12% of patients with spontaneous pneumothorax. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage. MATERIAL AND METHODS: From 1997 to 2002, 291 cases of spontaneous pneumothorax were treated in our department. Of these, 9 (3.09%) developed hemopneumothorax (> 400 ml). The clinical features of these patients and the results of conservative and surgical management were retrospectively reviewed. RESULTS: Seven patients were treated conservatively and two required VATS and thoracotomy because of worsening clinical condition. The amount of aspirated blood ranged from 400 to 3700 ml (mean, 1533 ml). Six patients received a homologous blood transfusion. CONCLUSIONS: In conclusion, hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Conservative treatment is adequate in most cases and should be performed if bleeding persists for less than 24 hours after chest tube placement.