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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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REFERENCES

References: 

Doğan R, Yüksel M, Çetin G, Süzer K, Alp M, Kaya S, et al. Surgical treatment ofhydatid cysts of the lung: report on 1055 patients. Thorax 1989;44:192-99.(PMID:2705149)
2.
Sağlı
k İstatistikleri. Ankara, Türkiye: Türkiye Cumhuriyeti Sağlık Bakanlığı, Araştırma, Planlama ve Koordinasyon Kurulu Başkanlığı; 2001.s.54.
3. Şahin E, Enön S, Cangır AK, Kutlay H, Kavukcu S, Akay H, et al. Single-stage transthoracic approach for right lung and liver hydatid disease. J Thorac Cardiovasc Surg 2003;126:769-73. (PMID: 14502152)
4. Peleg H, Best LA, Gaitini D. Simultaneous operation for hydatid cysts ofright lung and liver. J Thorac Cardiovasc Surg 1985;90:783-7. (PMID: 4058049)
5. Rami-Porta R, Ais-Conde JG, Bravo-Bravo JL, Alix-TruebaA, Serrano-MunozF. Treatmentofsynchronous pulmonary and hepatic hydatid cysts. J Thorac Cardiovasc Surg 1986;92:314-5. (PMID: 3736091)
6. Aribaş OK, Kanat F, Türk E, Kalaycı MU. Comparison between pulmonary and hepatopulmonary hydatidosis. Eur J Cardiothorac Surg 2002;21:489-96. (PMID:
11888769)
7. Karaoğlanoğlu N, Kürkcüoğlu İC, Görgüner M, Eroğlu A, Türkyılmaz A. Giant hydatid lung cysts. Eur J Cardiothorac Surg2001;19:914-7. (PMID: 11404152)
8. Harlaftis NN, Aletras HA, Panagiotis NS. Hydatid disease ofthe lung. In: Shields TW, Locicero J, Ponn RB, Rusch VW. General Thoracic Surgery. Philadelphia: Lippincott Williams and Wilkins, 2005;1298-1308.
9. Dhaliwal RS, Kalkat MS. One-stage surgical procedure for bilateral lung and liver hydatid cysts. Ann Thorac Surg 1997;64:338-41. (PMID: 9262571)
10. Haliloğlu M, Saatçi I, Akhan O, Özmen M, Besim A. Spectrum of imaging findings in pediatric hydatid disease. AmJRoentgenol 1997;169:1627-31. (PMID:
9393178)
11. Topçu S, Kurul İC, Taştepe İ, Bozkurt D, Gülhan E, Çetin G. Surgical treatment ofpulmonary hydatid cysts in children. J Thorac Cardiovasc Surg 2000;120:1097-101. (PMID: 11088032)
12. Kurul İC, Topçu S, Altınok T, Yazıcı U, Taştepe I, Kaya S, et al. One-stage operation for hydatid disease oflung and liver: Principles oftreatment. J Thorac Cardiovasc Surg2002;124:1212-5. (PMID: 12447189)
13. Erdoğan A, Ayten A, Kabukcu H, Demircan A. One-stage transthoracic operation for the treatment ofright lung and liver hydatid cysts. World J Surg 2005;29:1680-6. (PMID: 16311867)
S.D.Ü. Tıp pak.
Derg
. 2008:15(2)/1-5
Gezer, Kist hidatiklere tek aşamalı transtorasik yaklaşım
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14. Topçu S, Kurul İC, Altınok T, Yazıcı Ü, Demir A. Giant hydatid cysts oflung and liver. Ann Thorac Surg 2003;75:292-4. (PMID: 12537240)
15. Bret PM, Fond A, Bretagnolle M, Valette PJ, Thiesse P, Lambert R, et al. Percutaneous aspiration and drainage of hydatid cysts in the liver. Radiology 1988;168:617-20. (PMID: 3043542)'
16. Mueller PR, Dawson SL, Ferrucci JT, Nardi GL. Hepatic echinococcal cyst: successful percutaneous drainage. Radiology 1985;155:627- 8. (PMID:
3890001)
17. Şanlı M, Tunçözgür B, Elbeyli L. Pulmoner hidatidoz ve cerrahi tedavisi. Turkish J Thorac Cardiovasc Surg
2000;8:703-5.
18. Bulbuller N, Ilhan YS, Kirkil C, Yenicerioglu A, Ayten R, Cetinkaya Z. The results of surgical treatment for hepatic hydatid cysts in an endemic area. TurkJGastroenterol. 2006;17:273-8 (PMID: 17205405)
19. Khuroo MS, Wani NA, Javaid G, et al. Percutaneous drainage compared with surgery for hepatic hydatid cysts. N Engl J Med 1997; 337: 881-7. (PMID:
9302302)

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