Sheikhy Kambiz, Rouhani Ramin, Pejhan Saviz, Sanei Motlagh Alireza, Sheikhy Ali
Lung transplant Research Center (LTRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran.
Caspian J Intern Med. 2022 Winter;13(1):44-50. doi: 10.22088/cjim.13.1.44.
Hydatidosis is one of the most critical worldwide parasitic zoonotic diseases. The lung is the second most common site of hydatidosis. This study aimed to evaluate the clinical status, diagnosis, treatment, and radiological findings of pulmonary hydatid cyst in patients referred to tertiary lung center.
From April 2014 to July 2019, patients referred to Masih Daneshvari University Medical Center with the impression of alveolar hydatidosis included. Demographic data of 304 patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and cyst characteristics. Also, surgical procedures, medical treatments, and post-operative complications were recorded.
Pulmonary hydatidosis was confirmed for 234 patients. 55% of patients were males with the mean age of 45.1±16.6 years. The most common symptoms were cough (59.8%), dyspnea (31.1%), and hemoptysis (26%). Left lung, right lung, and bilateral involvement were reported in 40.1%, 55.1%, and 4.8% of cases, respectively. Cyst perforation (39.8%) was the most common intra-operative finding. Surgical interventions included thoracotomy, rigid bronchoscopy, cyst aspiration, and enucleation. The liver was the most concomitant organ involved due to pulmonary hydatidosis (16.6%). The most common postoperative complication was atelectasis, with the rate of 35.7%. 52.2% of patients were discharged within 10 days after surgery. No mortality was reported.
Sometimes atypical findings in different imaging modalities make the hydatid cyst diagnosis challenging. Although lobe involvement more than 50% has the indication for lobectomy, we conserved lobes with about 70% involvement in our institution, and patients had no postoperative complications.
包虫病是全球最严重的寄生虫人畜共患病之一。肺是包虫病的第二常见发病部位。本研究旨在评估转诊至三级肺病中心的肺包虫囊肿患者的临床状况、诊断、治疗及影像学表现。
纳入2014年4月至2019年7月转诊至马西赫·达内什瓦里大学医学中心、疑似肺泡型包虫病的患者。收集304例患者的人口统计学数据,包括临床症状、实验室检查、影像学表现、肺部受累部位及囊肿特征。同时记录手术操作、药物治疗及术后并发症。
234例患者确诊为肺包虫病。55%的患者为男性,平均年龄45.1±16.6岁。最常见的症状为咳嗽(59.8%)、呼吸困难(31.1%)和咯血(26%)。左肺、右肺及双侧受累的病例分别占40.1%、55.1%和4.8%。囊肿穿孔(39.8%)是最常见的术中发现。手术干预包括开胸手术、硬质支气管镜检查、囊肿穿刺抽吸及摘除术。肝脏是肺包虫病最常累及的伴随器官(16.6%)。最常见的术后并发症是肺不张,发生率为35.7%。52.2%的患者术后10天内出院。无死亡病例报告。
有时不同影像学检查的非典型表现会使包虫囊肿的诊断具有挑战性。尽管肺叶受累超过50%有肺叶切除术的指征,但在我们机构中,对于约70%受累的肺叶我们予以保留,且患者无术后并发症。