Background

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.

Aim

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.

Material and methods

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.

Results

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.

Conclusion

This endoscopic approach for liver and splenic hydatid cyst extending into thorax is feasible and averts morbidities of thoracotomy.

中文翻译：

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游走寄生虫：腹腔棘球蚴包虫囊肿的内镜处理

背景

微创手术为延伸到胸部的腹部包虫囊肿开辟了混合方法的途径。应评估这种腹腔镜和胸腔镜联合方法的可行性和有效性。

目标

目前的前瞻性研究旨在强调内窥镜方法在处理延伸到胸腔的肝脾复杂包虫囊肿中的可行性和实用性。

材料与方法

该研究包括接受腹腔镜和胸腔镜联合治疗的腹部包虫囊肿延伸至胸腔的患者，为期 4 年。研究了他们的临床特征、调查、影像学、治疗和住院时间。使用 Calvien Dindo 量表评估临床结果的发病率和死亡率。

结果

共研究了 15 名患者。所有患者均有胸腔棘球蚴囊肿，12例肝脏受累，2例脾脏受累，1例肝脏和脾脏均受累。最常见的症状是腹部疼痛11例（73.3%），其次是腹部肿块2例（13.33%），呼吸困难2例（13.33%）。计算机断层扫描对所有患者都具有诊断意义。最常见的类型是 Gomez 1 型（7 名患者），其次是 Gomez II 型（3 名患者）和 Gomez III 型（2 名患者）。平均手术时间为 120 分钟。平均住院时间为 10 天。胸腔积液是最常见的术后后遗症。

结论

这种用于肝脾包虫囊肿延伸到胸腔的内窥镜方法是可行的，并且可以避免开胸手术的并发症。