title: Management of complicated giant thoracic hydatid disease.
abstract: BACKGROUND
  Hydatid disease is a parasitic infestation frequently seen in sheep- and cattle-raising areas of the world, and has been known since the time of Galen and Hippocrates. We retrospectively evaluated patients who underwent surgery in our department due to complicated giant intrathoracic hydatid cysts.
  
  
  METHODS
  Twenty patients with complicated giant intrathoracic hydatid cysts were operated on between May 2001 and May 2007 in our department. There were 14 male and 6 female patients, with an age range from 10 to 47 years (mean 23.7+/-11.2 years).
  
  
  RESULTS
  The most common symptoms were cough, chest pain, fever, and dyspnea. The most common physical finding was decreased breathing sounds at the affected hemi-thorax. There were signs of cyst perforation of the bronchial space in 14 patients. The cysts were ruptured to the pleural space in 5 patients, with pleural effusion or localized empyema; 4 of them required decortication due to air trapping in the lung. The cyst was found to be intact but infected in 1 patient with cardiac cyst. Cystotomy plus capitonnage was the most frequently used surgical procedure, which was performed in 18 patients, while lobectomy was performed in 1 patient, and left ventriculotomy plus cystotomy plus capitonnage was performed in 1 patient.
  
  
  CONCLUSIONS
  All thoracic hydatid cysts should be operated on as soon as they are diagnosed in order to avoid complications, and surgery should be as conservative as possible. Since preoperative medical therapy can lead to perforation, additional adjuvant medical therapy should only be administered postoperatively to avoid recurrences.
authors: Department of Cardiovascular Surgery, Yüzüncü Yil University, Van, Turkey. drhasanekim@yahoo.com
authors: Hasan
authors: H
authors: Ekim
authors: Bülent
authors: B
authors: Ozbay
authors: Mehmet
authors: M
authors: Kurnaz
authors: Mustafa
authors: M
authors: Tuncer
authors: Meral
authors: M
authors: Ekim
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002417:Cattle; D002648:Child; D053715:Cystotomy / Q000379:methods; D004443:Echinococcosis / Q000175:diagnosis / Q000601:surgery*; D004445:Echinococcosis, Pulmonary / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000175:diagnosis / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D055815:Young Adult