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

Suleyman Demirel Universitesi TIP FAKULTESI DERGISI: 2008 Mart; 15 (2) Simultane sag akciger ve karaciger kist hidatiklerine tek asamali transtorasik yaklasim: 200 olgunun analizi Suat Gezer, Mehmet sirmali, Gokturk Findik, Hasan Turut, Gurhan Oz, Irfan Tastepe, Sadi Kaya, Guven Cetin Ozet, Amac: Kist hidatik, endemisi, progresyonu, ciddi komplikasyonlari ve nadiren spontan regrese olmasI nedeniyle onemli bir saglik sorunudur. Bu calismada simultane sag akciger ve karaciger kist hidatigi nedeni ile tek asamali transtorasik operasyon uyguladigImiz olgulari, sonuclarini ve bu yaklasimin degerini incelemeyi amacladIk. Materyal ve Metod: Hastanemizde 1994 ile 2006 yillari arasinda 200 hastaya simultane sag akciger ve karaciger kist hidatigi nedeni ile tek asamali transtorasik operasyon uygulandi. Hastalarin yas, cinsiyet, belirti ve bulgulari, operatif yaklasim, postoperatif morbidite, mortalite ve izlem sonuclarI degerlendirildi. Bulgular: Tum hastalara sag torakotomi uygulandI. Oncelikle akciger kistine, sonra diyafragma acIlarak karaciger kistine mudahale edildi. Opere edilen 200 hastanIn 97.si erkek, 103.u kadin olup ortalama yaslari 28,2 idi. Oksuruk ve gogus agrisi en sik karsilasilan semptomlar iken 16 hasta asemptomatik idi. Postoperatif donemde 5 hastada asIrI safra drenaji ve 3 hastada bronkobiliyer fistul gelisti. Bu hastalar nazoduodenobiliyer drenaj ile tedavi edildi. Hic peroperatif mortaliteye rastlanmadi. Sonuc: Simultane sag akciger ve subdiyafragmatik karaciger kist hidatigi olan hastalarda akciger operasyonu ile birlikte transdiyafragmatik yoldan karaciger kistine mudahale edilmesi guvenilir ve etkili bir yontemdir. Anahtar kelimeler: Kist hidatik, Es zamanli akciger ve karaciger kist hidatigi, Transtorasik yaklasim. Abstract Single stage transthoracIc approach to sImultaneous rIght lung and lIver hydatId cysts 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