{Reference Type}: Journal Article
{Title}: Wandering parasite: endoscopic management of hydatid cysts of abdomen encroaching thorax.
{Author}: Bhandarwar A;Tandur A;Bharadwaj G;Chatnalkar S;Wagh A;Bakhshi G;
{Journal}: Surg Endosc
{Volume}: 35
{Issue}: 12
{Year}: Dec 2021
{Factor}: 3.453
{DOI}: 10.1007/s00464-021-08682-w
{Abstract}: <B>BACKGROUND: </B>Minimal access surgery has opened avenues of hybrid approach for abdominal hydatid cysts extending into thorax. This approach of combined laparoscopy and thoracoscopy should be evaluated for its feasibility and efficacy.<BR><B>OBJECTIVE: </B>Present prospective study was designed to highlight the feasibility and utility of endoscopic approach in the management of complex hydatid cyst of the liver and spleen extending into the thorax.<BR><B>METHODS: </B>Patients undergoing combined Laparoscopy and thoracoscopy for abdominal hydatid cysts extending into thorax over a period of 4 years were included in the study. Their clinical features, investigations, imaging, treatment and duration of hospital stay were studied. Clinical outcomes were assessed with respect to morbidity and mortality using Calvien Dindo scale.<BR><B>RESULTS: </B>A total of 15 patients were studied. All patients had thoracic hydatid cysts with liver involvement in 12, splenic involvement in 2, and both liver and spleen in 1 patient. The most common symptom was pain in the abdomen in 11 patients (73.3%) followed by lump in the abdomen in 2 patients (13.33%), and dyspnoea in 2 patients (13.33%). Computed Tomography was diagnostic in all patients. Most common type was Gomez type 1 (7 patients) followed by Gomez type II (3 Patient) and Gomez type III (2 patient). The mean operative time was 120 min. Mean hospital stay was 10 days. Pleural effusion being the commonest postoperative sequelae.<BR><B>CONCLUSIONS: </B>This endoscopic approach for liver and splenic hydatid cyst extending into thorax is feasible and averts morbidities of thoracotomy.