Basic Operative Tactics for Pulmonary Echinococcosis in the Era of Endostaplers and Energy Devices

Author:

Bakinowska Estera1,Kostopanagiotou Konstantinos2,Wojtyś Małgorzata Edyta1ORCID,Kiełbowski Kajetan1ORCID,Ptaszyński Konrad3,Gajić Darko1,Ruszel Nikola4,Wójcik Janusz1ORCID,Grodzki Tomasz1,Tomos Periklis2

Affiliation:

1. Department of Thoracic Surgery and Transplantation, Pomeranian Medical University in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland

2. Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, 12462 Athens, Greece

3. Department of Pathology, Faculty of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland

4. Department of Internal Medicine and Hypertension with Subdepartment of Cardiology, Independent Public Provincial Hospital in Szczecin, Alfreda Sokołowskiego 11, 70-891 Szczecin, Poland

Abstract

Human echinococcosis is a zoonotic infection caused by the larvae of the tapeworm species Echinococcus. The liver is the most common location for a primary echinococcosis. However, the parasite may bypass or spread from the liver to the lungs, causing primary or secondary pulmonary echinococcosis, respectively. Pulmonary echinococcosis is a clinically challenging condition in which anthelminthic regiments are important, but surgery has the central role in removing the cysts and preventing recurrences. Surgical treatment may involve cystotomy, enucleation, capitonnage, or atypical resections, which occasionally are in combination with hepatic procedures. The utilization of modern devices is greatly underdescribed in surgery for thoracic infections, even though these facilitate much of the work. Therefore, this article aims to describe pulmonary echinococcosis and the role of modern surgical devices in the treatment process. Furthermore, we report surgical treatment of three different cases of pulmonary echinococcosis. Surgeries of uncomplicated and ruptured hepatic or pulmonary cysts are described. Simple small pulmonary echinococcal lesions can be excised by endostaplers both for diagnostic and curative reasons. Larger cysts can be removed by energy devices unless large bronchial air leaks occur. Complicated cysts require treatment by more extensive techniques. Inexperienced surgeons should not abstain but should carefully decide preoperatively how to proceed.

Publisher

MDPI AG

Subject

General Medicine

Reference61 articles.

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4. Hydatid Lung Disease (Echinococcosis/Hydatidosis);Gottstein;Clin. Chest Med.,2002

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