Modified capitonnage technique for giant pulmonary hydatid cyst surgery

Abstract

Objectives: This study investigated the effectiveness of the modified technique (Aydin Technique), which was applied for capitonnage in the surgical treatment of giant pulmonary hydatid cysts.

Methods: Twenty-two cases were operated on for giant hydatid cysts with a total of 23 modified techniques for capitonnage (bilateral giant hydatid cyst in 1 case) in our clinic between January 2018 and December 2020. The demographic data were recorded.

Results: Thirteen out of 22 (59.1%) of cases were male and 9 (40.9%) were female. The mean age was 22.0 ± 15.8 and 14 cases (63.6%) were children. Hydatid cysts were intact in 13 (56.5%) cases and ruptured in 10 (43.5%) cases. Hydatid cyst diameters were on average 123 ± 21 mm. A modified method was performed for capitonnage in all cases while decortication was performed in 2 (8.7%) cases due to pleural thickening. Radiological atelectasis was observed in 6 cases (27.3%) postoperatively. The patients with atelectasis recovered without any clinical problem and no intervention was needed. In 1 case, an infection developed at the incision site. Postoperative prolonged air leak, empyema and mortality were not observed in any of the cases. The postoperative mean length of hospital stay was 7.18 ± 2.15 days. The mean follow-up period was 19.5 ± 11.5 months. No recurrence was encountered in the follow-up of the patients.

Conclusions: The results of this study may suggest to perform this new-described modified Aydin technique to avoid major capitonnage complications of the giant pulmonary hydatid cyst surgery.

Keywords: Giant; Hydatid cyst; Modified technique; Morbidity; Surgery.

Figure 1:

Intraoperative hydatid cyst fluid aspiration (A), cleaning of the cyst cavity with povidone-iodine soaked sponges after germinative membrane removal (B) and detection of bronchial orifices opening into the cavity by providing pulmonary ventilation after filling the cavity with saline are shown (C).

Figure 2:

The modified method applied for capitonnage starting from the base of the cavity (A and B) and finally the continuous suturing of the edges are shown (C).

Figure 3:

Preoperative (A) and postoperative posteroanterior chest radiographs (B) of 2 giant pulmonary cysts of 120 mm in the right middle lobe and 150 mm in the left lower lobe of a 36-year-old male patient are shown.