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Simültane sağ akciğer ve karaciğer kist hidatiklerine tek aşamalı transtorasik yaklaşım: 200 olgunun analizi

Single stage transthoracıc approach to simultaneous rıght lung and lıver hydatid cysts

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Abstract (2. Language): 
Objective: Hydatid disease is an important health problem due to being endemic and progressive, and having rare spontaneous regression. In this study, we aimed to evaluate the cases in which a single-stage transthoracic surgery was applied for simultaneous right lung and liver hydatid disease, and outcomes and value of this approach. Materials and Methods: In our hospital, a single-stage transthoracic surgery was applied for simultaneous right lung and liver hydatid disease in 200 patients between 1994 and 2006. Age, sex, symptoms and presentations, operative approaches, postoperative morbidity and mortality, and follow-up of the patients results were evaluated. Results: A right thoracotomy was performed in all patients. first the lung cysts and later -after opening the diaphragma- liver cysts were resected. Of the 200 operated patiens, 97 were male and 103 were female and mean age was 28.2. While cough and chest pain were the most common symptoms, 16 patients were asymptomatic. Excessive bile drainage in 5 patients and bronchobiliary fistula in 3 patients were observed in postoperative period. These patients were managed with nasoduodenobiliary drainage. No mortality was encountered. Conclusion: A transdiaphragmatic liver cyst management with lung surgery is a reliable and effective method in patients with simultaneous right lung and subdiaphragmatic liver hydatid disease patients.
Abstract (Original Language): 
Amaç: Kist hidatik, endemisi, progresyonu, ciddi komplikasyonları ve nadiren spontan regrese olması nedeniyle önemli bir sağlık sorunudur. Bu çalışmada simültane sağ akciğer ve karaciğer kist hidatiği nedeni ile tek aşamalı transtorasik operasyon uyguladığımız olguları, sonuçlarını ve bu yaklaşımın değerini incelemeyi amaçladık. Materyal ve Metod: Hastanemizde 1994 ile 2006 yılları arasında 200 hastaya simültane sağ akciğer ve karaciğer kist hidatiği nedeni ile tek aşamalı transtorasik operasyon uygulandı. Hastaların yaş, cinsiyet, belirti ve bulguları, operatif yaklaşım, postoperatif morbidite, mortalite ve izlem sonuçları değerlendirildi. Bulgular: Tüm hastalara sağ torakotomi uygulandı. Öncelikle akciğer kistine, sonra diyafragma açılarak karaciğer kistine müdahale edildi. Öpere edilen 200 hastanın 97'si erkek, 103'ü kadın olup ortalama yaşları 28,2 idi. Öksürük ve göğüs ağrısı en sık karşılaşılan semptomlar iken 16 hasta asemptomatik idi. Postoperatif dönemde 5 hastada aşırı safra drenajı ve 3 hastada bronkobiliyer fistül gelişti. Bu hastalar nazoduodenobiliyer drenaj ile tedavi edildi. Hiç peroperatif mortaliteye rastlanmadı. Sonuç: Simültane sağ akciğer ve subdiyafragmatik karaciğer kist hidatiği olan hastalarda akciğer operasyonu ile birlikte transdiyafragmatik yoldan karaciğer kistine müdahale edilmesi güvenilir ve etkili bir yöntemdir.
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