capitonnage

  • 文章类型: Case Reports
    细粒棘球蚴引起包虫囊肿,一种重要的人畜共患和肺寄生虫病,可以模仿各种病理,通常比疾病本身更难控制。包虫囊肿在印度被认为是一个重大的健康问题,伊朗,中国,地中海国家,缺乏令人满意的环境卫生,预防医学,和兽医服务。棘球蚴病仍然是几个国家的主要社区健康负担,在一些地形中,它构成了一种新出现和重新出现的疾病。囊性包虫病是该属最常见的人类疾病,它在全球范围内占了很大比例。在这里,涉及一名11岁发烧的病例,干咳,出现右侧软骨下痛,影像学显示肺部有包虫囊肿.在单肺通气和使用双腔气管导管(DLET或DLT)插管的麻醉下,通过右后外侧开胸手术切除囊肿。尽管对手术方法缺乏共识,但仍强调手术是主要治疗方法。这个案例强调了个性化的有效性,即使是大型的保留实质的手术,简单的囊肿,表明预后良好。
    Echinococcus granulosus causes hydatid cysts, a significant zoonotic and pulmonary parasitic disease that can mimic various pathologies and is often harder to manage than the disease itself. A hydatid cyst is considered a significant health problem in India, Iran, China, and Mediterranean countries, which lack satisfactory environmental health, preventive medicine, and veterinarian services. Echinococcosis continues to be a major community health burden in several countries, and in some terrains, it constitutes an emerging and re-emerging disease. Cystic echinococcosis is the most common human disease of this genus, and it accounts for a significant number of cases worldwide. Herein, a case involving an 11-year-old presenting with fever, dry cough, and right hypochondrial pain is presented, where imaging revealed a hydatid cyst in the lung. Surgical removal of the cyst was achieved through right posterolateral thoracotomy under one-lung ventilation and anesthesia using intubation with a double-lumen endotracheal tube (DLET or DLT), highlighting surgery as the primary treatment despite the lack of consensus on surgical methods. This case underscores the effectiveness of individualized, parenchyma-preserving surgery for even large, uncomplicated cysts, indicating a positive prognosis.
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  • 文章类型: Journal Article
    目的:包虫囊肿可以发生在任何地方,如肝脏,肺,脾,脾肾,大脑,和软组织。肺包虫囊肿比肝包虫囊肿更容易破裂。在这项研究中,我们旨在呈现人口特征,临床症状,放射学发现,手术发现,进行的手术类型,肺包虫囊肿患者的术后并发症。
    方法:对我院2011年1月至2021年10月收治的94例肺包虫囊肿患者的资料进行回顾性分析。将患者分为两组:破裂的肺包虫囊肿和未破裂的肺包虫囊肿。
    结果:94例接受肺包虫囊肿手术的患者共检出120例肺包虫囊肿。63例(52.5%)患者发现囊肿破裂。直径<10cm的囊肿破裂率明显较高(p=0.005)。在破裂组中,发烧和咯血的投诉明显更高。6例患者术后平均2个月发现气胸,其中一名患者接受了电视辅助胸腔镜检查(VATS).
    结论:在包虫病流行地区出现下呼吸道症状的儿童应注意肺包虫囊肿。保留薄壁组织的方法应该是治疗肺包虫囊肿的首选方法。发生术后早期并发症的患者也应密切关注晚期障碍。
    OBJECTIVE: Hydatid cysts can occur in any place such as the liver, lung, spleen, kidney, brain, and soft tissue. Pulmonary hydatid cysts are more prone to rupture than liver hydatid cysts. In this study, we aimed to present the demographic characteristics, clinical symptoms, radiological findings, surgical findings, type of surgery performed, and postoperative complications of patients with pulmonary hydatid cysts.
    METHODS: The files of 94 patients who were operated on for pulmonary hydatid cysts in our clinic between January 2011 and October 2021 were retrospectively analyzed. The patients were divided into two groups: ruptured pulmonary hydatid cysts and non-ruptured pulmonary hydatid cysts.
    RESULTS: A total of 120 pulmonary hydatid cysts were detected in 94 patients who were operated on for pulmonary hydatid cysts. Cyst rupture was detected in 63 (52.5%) patients. Rupture was found significantly higher in cysts with a diameter of <10 cm (p=0.005). Complaints of fever and hemoptysis were found significantly higher in the ruptured group. Pneumothorax was detected in six patients after the operation with an average of two months, one of which was the patient who underwent video-assisted thoracoscopy (VATS).
    CONCLUSIONS: Pulmonary hydatid cyst should be kept in mind in children presenting with lower respiratory tract symptoms in regions where echinococcosis is endemic. Parenchyma-sparing methods should be the first choice in the management of pulmonary hydatid cysts. Patients who develop early postoperative complications should also be followed closely for late impediments.
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  • 文章类型: Journal Article
    目的:虽然包虫病是印度普遍存在的人畜共患病,在印度,关于胸包虫病(THD)的管理的文献很少。没有可用的手术指南。这项研究的目的是分析印度三级医院中THD的详细信息,并提出其管理方案。
    方法:检索了2009年至2019年在我们机构接受THD手术的所有成年患者的病例档案,并进行了回顾性研究。
    结果:共有186名患者,男性103人(55.4%),女性83人(44.6%),研究对象的平均年龄为34.2岁.最常见的症状是咳嗽,83例(44.6%)。22例(11.8%)患者出现并发症。在大多数患者中,计算机断层摄影(CT)是确证的。在135例(72.6%)患者中发现了孤立的肺部疾病,其中153例(82.3%)单叶受累。56例右下叶最常见(30.1%)。肺外,6例(3.2%)患者出现胸内受累,45例(24.2%)患者出现同步胸外疾病.所有患者均开始使用驱虫药。后外侧开胸手术是最常见的手术方法。20例(10.7%)患者需要肺切除。平均住院时间为5.9天。漏气,见于10例(5.4%)患者,是最常见的术后并发症。有单一的院内死亡率。年龄,糖尿病,发现囊肿的继发细菌感染和囊肿特征显着影响手术结局。
    结论:手术,THD的治疗选择,可以在发病率和死亡率可忽略不计的情况下完成,应加快以预防并发症。术前应该识别风险因素,以便更好地做出决策。适当的同步药物治疗可以防止复发。长期随访是检测晚期复发的必要条件。
    OBJECTIVE: Though hydatidosis is a ubiquitous zoonosis endemic to India, there is a dearth of literature regarding the management of thoracic hydatid disease (THD) in India. There are no surgical guidelines available. The aim of this study is to analyse the details of THD operated upon in a tertiary care hospital in India and propose a protocol for its management.
    METHODS: The case files of all adult patients operated upon for THD in our institution between 2009 and 2019 were retrieved and a retrospective study done.
    RESULTS: A total of 186 patients, 103 (55.4%) males and 83 (44.6%) females, with a mean age of 34.2 years were studied. The commonest symptom was cough as in 83 (44.6%) patients. Complications were seen in 22 (11.8%) patients. Computerized tomogram (CT) was confirmatory in most patients. Isolated pulmonary disease was seen in 135 (72.6%) patients with 153 (82.3%) uni-lobar involvement. Right lower lobe was most frequently involved as in 56 (30.1%). Extra-pulmonary, intra-thoracic involvement was seen in 6 (3.2%) and synchronous extra-thoracic disease in 45 (24.2%) patients. All patients were initiated on anthelmintics. Postero-lateral thoracotomy was the commonest surgical approach. Twenty (10.7%) patients required lung resections. The mean hospital stay was 5.9 days. Air leak, seen in 10 (5.4%) patients, was the commonest post-operative complication. There was single in-hospital mortality. Age, diabetes mellitus, secondary bacterial infection of the cyst and cyst characteristics were found to significantly affect the surgical outcomes.
    CONCLUSIONS: Surgery, the treatment of choice for THD, can be done with negligible morbidity and mortality and should be expedited to prevent complications. Risk factors should be identified pre-operatively for better decision-making. Adequate concurrent medical therapy may prevent recurrences. Prolonged follow-up is mandatory to detect late recurrences.
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  • 文章类型: Journal Article
    UNASSIGNED: Pulmonary hydatid cyst disease is still a major problem in countries like South Africa (SA), where livestock farming is common. Hydatidosis has a variable clinical course depending on the size, location and complications of the cyst. For pulmonary cysts of any size, surgery remains the gold standard for treatment, with lung conservation surgery being the ideal.
    UNASSIGNED: To describe the epidemiology, clinical presentation, surgical management, and surgical outcomes of paediatric pulmonary hydatid disease in children referred to the Department of Cardiothoracic Surgery at Inkosi Albert Luthuli Central Hospital (IALCH) in KwaZulu-Natal Province, SA.
    UNASSIGNED: We retrospectively reviewed and analysed the medical records of 38 children between the ages of 0 and 18 years with pulmonary hydatid cysts, who were referred to the Department of Cardiothoracic Surgery at IALCH and underwent surgical management between 1 January 2008 and 31 December 2018. The medical records were evaluated for patients\' demographics, clinical evaluation, surgical management strategies and surgical outcomes.
    UNASSIGNED: Of the 38 patients, 60.5% were male, with a mean age of 6.5 years. More than two-thirds of the patients (68.4%) were from the Eastern Cape and 31.6% were from KwaZulu-Natal. The majority of the cysts (84.2%; n=32) were classified as large (5 - 9 cm in diameter) and giant (≥10 cm in diameter). Forty-eight surgical procedures were performed and lung preservation surgery by enucleation and capitonnage was preferred. Some patients developed postoperative complications such as prolonged air leaks from bronchopleural fistula (18.8%; n=9) and 88.9% (n=8) of these patients healed with chest tube drainage and physiotherapy. Lung resection was only required in 4% (n=2) of the patients. The mean (standard deviation) number of days spent in hospital was 7 (4) days. All children survived with no recurrences.
    UNASSIGNED: Conservative surgical procedures such as enucleation of the cysts of any size are possible, safe, reliable and reproducible.
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  • 文章类型: Journal Article
    目的:本研究的目的是考虑两组患者在进行腹部成形术时对术后并发症的使用。
    方法:从2017年1月1日至2019年12月31日,215例患者在我们机构接受了腹部成形术。在这次回顾中,比较,单一机构研究,患者分为两组:“引流”D(n=162)当吸引完成腹部成形术时,当抽吸未完成腹壁成形术时,“无引流”ND(n=53)。检索各组的早期和远处并发症并进行比较。
    结果:两组术后血清肿发生率无明显差异(D组8%,AD组11.3%)。与无引流组ND相比,引流组D经历了更多的血清肿穿刺(2,3±1,0),穿刺液的平均值更高(386,5ml±350,4ml)(1,3-0,5个穿刺次数,平均穿刺液为165,8mL±224,2mL)。ND组的平均住院时间(2,9±1,8天)短于D组(4,4-1,7天),P<0,0001。
    结论:在统计学上采用缝制缝合但减少引流的方式进行腹部成形术似乎不会增加术后并发症。作者建议,打着缝缝线的幌子,不要系统地引流腹部成形术,并将此技术保留给有并发症风险的患者(高BMI,显著的体重减轻和合并症)。
    OBJECTIVE: The purpose of this study was to consider the use of drainage when performing an abdominoplasty with regards to postoperative complications for two groups of patients.
    METHODS: From January 1st 2017 to December 31th 2019, 215 patients underwent an abdominoplasty in our institution. In this retrospective, comparative, single institution study, patients were divided into two groups: \"drainage\" D (n=162) when suction completed abdominoplasty, \"no drainage\" ND (n=53) when suction didn\'t completed abdominoplasty. Early and distant complications were retrieved for each group and compared.
    RESULTS: There was no significant difference between the two groups concerning the occurrence of seroma postoperatively (8% of patients in group D and 11.3% of patients in group AD). The drainage group D experienced more seroma\'s punctures (2,3± 1,0) and the mean of punctured fluid was higher (386,5ml±350,4ml) compared to the no drainage group ND (1,3+- 0,5 number of punctures with a mean punctured fluid of 165,8mL± 224,2mL). The mean hospital stay was shorter for group ND (2,9± 1,8 days) than for group D (4,4+- 1,7 days), P<0,0001.
    CONCLUSIONS: Performing an abdominoplasty with quilting suture but drainless doesn\'t seem to increase postoperative complications statistically. The authors recommend, under the guise of a quilting suture, not to systematically drain the abdominoplasties and to reserve this technique for patients at risk of complications (high BMI, significant weight loss and co-morbidities).
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  • 文章类型: Journal Article
    目的:本研究的目的是描述我们用于肝包虫囊肿的外科治疗的腔内资本减少技术,通过介绍使用该技术进行手术的患者的短期和长期结局,为文献做出贡献。
    方法:2016年1月至2019年12月,对12例肝包虫囊肿患者进行了引流和内头技术。
    结果:病例平均年龄为36.25±12.5岁,有7名女性和5名男性。所有病例右上腹疼痛,和5例的饱腹感。没有一例囊肿破裂,黄疸,或其他临床表现。8例术前实验室检查结果正常。术中胆管-囊肿沟通8例(66.7%)。病例平均随访38.1个月(范围,24-88个月)。
    结论:有/没有选择性胆管修复的引流/内头管是一种可以在有经验的手中以非常低的发病率和死亡率进行的技术,特别是集中的包虫囊肿。
    OBJECTIVE: The aim of the present study is to describe the cavity-reducing internal capitonnage technique that we used for the surgical therapy of liver hydatid cyst, and contribute to the literature by presenting the short- and long-term outcomes of the patients who were operated on with this technique.
    METHODS: A drainage and internal capitonnage technique was performed on 12 cases due to liver hydatid cyst in our clinic between January 2016 and December 2019.
    RESULTS: The mean age of cases was 36.25 ± 12.5 years, with 7 females and 5 males. All cases had pain in the right upper quadrant, and a sense of fullness in 5 cases. None of the cases had ruptured cysts, jaundice, or other clinical manifestations. The preoperative laboratory findings were normal in 8 cases. Intraoperative biliary-cyst communication was demonstrated in 8 cases (66.7%). Cases were followed up for a mean duration of 38.1 months (range, 24-88 months).
    CONCLUSIONS: The drainage/internal capitonnage with/without selective bile duct repair is a technique that can be performed with very low morbidity and mortality rates in experienced hands, especially for centrally located hydatid cysts.
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  • 文章类型: Journal Article
    UNASSIGNED: Pulmonary hydatid cyst is a parasitic disease causing an endemic and a health burden in many regions. Lung cysts are more common than liver cysts in children and patients may remain asymptomatic. Cyst rupturing is not uncommon, and it is considered the most feared complication. In this cohort study, we aimed to identify the risk factors related to cyst rupture in a Jordanian pediatric population.
    UNASSIGNED: We retrospectively evaluated all pediatric patients who underwent cystostomy and capitonnage for pulmonary hydatid cyst between 2003 and 2020 at King Abdullah University Hospital.
    UNASSIGNED: We found 43 patients with a mean age of 13 ± 4 years who suffered from 61 pulmonary cysts. 55.6% of them were males. The most prevalent symptom was shortness of breath. The rupture rate for patients was 39.5%, and 29.5% for cysts. None of the patients with cyst rupture had an anaphylactic reaction. The left lower lobe was the most common location for both intact and ruptured cysts. 25.6% of the patients had giant cysts (>10 cm) with a mean of 7.4 cm for all cysts. Patients with intact cysts had higher-rates of cough (42.3% vs. 29.4%) and lower-rates of shortness of breath (34.6% vs. 52.9%) than patients with ruptured cysts, which were not statistically significant. Although statistically insignificant, patients with ruptured cysts tended to have multiple cysts in one lung (29.4% vs. 7.7%, p = 0.180), and more complication rates (29.4% vs 7.7%, p = 0.09). Both groups had almost identical IgG-ELISA positive results. We found no significant association between cyst rupture and age, gender, presenting symptoms, cyst size, cyst location, and rate of postoperative complications.
    UNASSIGNED: The rupture of pulmonary hydatid cyst has clinical consequences in pediatric patients, further studies on larger populations are needed to identify factors that make patients more prone to rupture and prioritize them for clinical monitoring and management.
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  • 文章类型: Case Reports
    Diagnosis and treatment of liver hydatid cysts may be challenging. Many surgical techniques have been proposed for the treatment of liver hydatid cysts, but the problem of the residual cavity still remains controversial and challenging, especially in giant liver hydatid cysts which are rare entities that have not been widely described in the literature so far. Capitonnage, external tube drainage and omentoplasty are the most commonly used techniques. Herein, we report the case of a 70-year-old man with a mild upper quadrant pain that proved to have a giant liver hydatid cyst, 21*14 cm2, occupying the entire right lobe of the liver. We describe a successful surgical approach with cyst unroofing and careful evacuation of the multiple daughter cysts by aspiration, and the effective management of the residual cavity by the combination of all three aforementioned techniques.
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  • DOI:
    文章类型: Journal Article
    包虫囊肿病是由寄生虫细粒棘球蚴引起的,是儿童时期的重要健康问题。在本研究中,我们的目的是根据相关文献报告我们在25例手术治疗小儿包虫囊肿病例中的经验。
    我们回顾性分析了2005年至2016年间在我们诊所接受肺包虫囊肿治疗的25例15岁以下患者。对患者进行年龄分析,性别,症状和体征,诊断方法,囊肿定位,直径,number,治疗方式,死亡率,发病率,并复发。
    在这项临床研究中纳入的25名患者中,16人为男性,平均年龄为10.5(范围5-15)岁。最常见的症状是阵发性咳嗽,影响了18例患者。囊肿位于肺23例,肺和肝2例。19个肺囊肿是孤立的,21例(66%)位于下叶。13例(52%)患者有囊肿穿孔。14例(56%)患者接受了膀胱切开术和头颅手术,9例(36%)膀胱切开术,和2(8%)的眼球摘除。在平均12个月(范围8-18个月)的随访中没有观察到复发病例。
    手术是小儿肺包虫囊肿疾病的主要治疗方法。膀胱切开术和头颅是最常用的薄壁组织保留技术。
    UNASSIGNED: Hydatid cyst disease is caused by the parasite Echinococcus granulosus and it is an important health problem in the childhood period. In the present study, we aimed to report our experience in 25 surgically managed pediatric hydatid cyst cases under the light of the relevant literature.
    UNASSIGNED: We retrospectively analyzed 25 patients below 15 years of age who were treated for pulmonary hydatid cyst at our clinic between 2005 and 2016. The patients were analyzed for age, sex, signs and symptoms, diagnostic methods, cyst localization, diameter, number, treatment modalities, mortality, morbidity, and recurrences.
    UNASSIGNED: Of the 25 patients included in this clinical study, 16 were male and their mean age was 10.5 (range 5-15) years. The most common presenting symptom was paroxysmal cough which affected 18 patients. The cysts were located in lungs in 23 patients and lungs and liver in 2 patients. Nineteen pulmonary cysts were solitary, and 21 (66%) were in the lower lobe. Thirteen (52%) patients had perforated cysts. Fourteen (56%) patients were operated with cystotomy and capitonnage, 9 (36%) with cystotomy, and 2 (8%) with enucleation. No case of recurrence was observed during an average 12 (range 8-18) months of follow-up.
    UNASSIGNED: Surgery is the primary treatment of pediatric pulmonary hydatid cyst disease. Cystotomy and capitonnage is the most commonly used parenchyma sparing technique.
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  • 文章类型: Comparative Study
    BACKGROUND: Pulmonary hydatid disease remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. However, there is no scientific consensus over selection of these operative interventions.
    OBJECTIVE: The aim of this study is to compare these two methods: capitonnage and uncapitonnage in the surgery of childhood pulmonary hydatid cyst in regard to the postoperative period.
    METHODS: This is a retrospective analysis of 136 patients operated for pulmonary hydatid disease between January 2010 and July 2017 according to two techniques. Group A was cystotomy with capitonnage (n = 76), and group B was cystotomy alone (n = 60). We compared the postoperative outcomes.
    RESULTS: Our data showed pneumothorax(PNO) and emphysema were seen in 30% of Group B and only in 13.2% in Group A, and the persistence of residual cavity in 23.3% in Group B and 7.9% in Group A (p = 0.014). We have not seen any case of recurrence with capitonnage.
    CONCLUSIONS: We conclude that capitonnage appears to prevent PNO and emphysema formation and a remaining residual cavity in the long term with a significant difference. And it prevents prolonged postoperative air leak and hospitalization with a slightly nonsignificant difference. It is difficult to say with absolute certainty that the noncapitonnage group is inferior to the capitonnage group, since several factors can influence the evolution.
    METHODS: Clinical research article Level of evidence III.
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