REVIEW
Capitonnage or not? Which is the best operative technique for hydatid cysts of the lung; when should it be performed?
Fatmir Caushi 1  
,   Gentiana Qirjako 2,   Armela Çuko 3,   Rezart Oketa 1,   Agron Menzelxhiu 1,   Alban Hatibi 4
 
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1
Department of Thoracic Surgery, University Hospital of Lung Diseases, Tirane, Albania
2
Department of Public Health, Faculty of Medicine, Tirana University, Albania
3
Department of Pneumonology, University Hospital of Lung Diseases, Tirane, Albania
4
Department of Intensive Care, University Hospital of Lung Diseases, Tirane, Albania
CORRESPONDING AUTHOR
Fatmir Caushi   

University Hospital of Lung Diseases, Sauk, Tirane, Albania
 
Pneumon 2011;24(2):177–181
 
KEYWORDS
ABSTRACT
Objectives:
Echinococcosis is a biological, medical, economic and social issue of great importance. This study was undertaken because differing opinions have been expressed about the most successful method of surgical treatment of pulmonary echinococcal cysts.

Methods:
The medical records of 181 patients with pulmonary hydatidosis treated in University Hospital of Lung Diseases were investigated retrospectively, of which 145 (80.1%) were treated surgically and the others conservatively. Of the patients, 93 (51.4%) were male and 88 (48.6%) were females, with a mean age of 40 years (range 12-80 years). In 31.1% of cases, the cysts were intact and in 68.9% complicated. The data were analyzed statistically using the Anova and Chi- square tests.

Results:
Only a few of the cases treated surgically had complications (34.8%), mainly air leakage (>7 days), but there were no fatalities. The mean number of days of postoperative hospitalization for all the surgical cases was 12.8±3.73. The mean number days of postoperative hospitalization for cases where capitonnage was applied was 11.38 ± 4.6 and the duration of air leak was 4.51±2.89 days. There was no statisticially significant association between surgical method and postoperative hospitalization.

Conclusions:
We concluded that the use of capitonnage offered no advantage concerning the days of hospitalization, and that its application is not the best choice in the surgical treatment of pulmonary echinococcosis. We also concluded that as complicated hydatid cysts prolong the hospitalization of the patients, it is better to treat them surgically at an early stage.

CONFLICTS OF INTEREST
There is no conflict of interest for the co-authors of this article
FUNDING
There is no fund or grant of support.
 
REFERENCES (24)
1.
Besim Elezi. Monograph of Hydatidosis. Departament of General Surgery, Faculty of Medicine, University of Tirana. Publication 2000; 3-8.
 
2.
Symbas PN, Aletras H. Hydatid disease of the lung. In: Shields WT, ed. General Thoracic Surgery. 5th ed. Philadelphia: Williams & Wilkins, 2000:1113-22.
 
3.
Varela A, Burgos R, Castedo E. Parasitic diseases of the lung and pleura. In: F. Griffith Pearson, Thoracic Surgery. Second Edition. 2002: 613-632.
 
4.
Patlakas G, Bouros D, Tzouvelekis A, Koulelidis A, Oikonomou A, Zacharis G. Ruptured echinococcus cyst. Pneumon 2010, 23:392.
 
5.
Anastasiou N, Kouppari G, Perraki E, et al. Cholobronchial fistula caused by an hepatic hydatid cyst. Pneumon 2001, 14:86-93.
 
6.
Konstantinou M, Fotinou M, Papamichalis G, Kotoulas C, Lioulias A, Triggidou R. Inflammatory pseudotumor of the lung: our experience. Pneumon 2006, 19:49-53.
 
7.
Pechlivanidou R, Roussi P, Moraitaki P, et al. Pulmonary echinococcosis presenting as a pulmonary mass with fever and haemoptysis; a case report. Pneumon 2010;23:180-183.
 
8.
Akn Kuzucu, Ömer Soysal, Mehmet Özgel, Saim Yologlu. Complicated hydatid cysts of the lung: clinical and therapeutic issues. Ann Thorac Surg 2004;77:1200-1204.
 
9.
Demirleau J, Pernot J. Technique et Indications Theėrapeutiques de Ia Kystectomie dans le Traitement du Kyste Hydatique du Poumon. Chir Paris 1951;67:796.
 
10.
Surgery of Hydatid Disease, Farrokh Saidi, WB Saunders, Philadelphia-London-Toronto, 1976, ISBN 978-0721679006.
 
11.
Celik M, Senol C, Keles M, et al. Surgical treatment of pulmonary hydatid disease in children: report of 122 cases. J Pediatr Surg 2000;35:1710–1713.
 
12.
Ayuso LA, de Peralta G, Lazaro RB, Stein AJ, Sanchez JA, Aymerich DF. Surgical treatment of pulmonary hydatosis. J Thorac Cardiovasc Surg 1981; 82:75.
 
13.
Novick RJ, Tchervenkov CI, Wilson JA, Munro DD, Mulder DS. Surgery for thoracic hydatid disease: a North American experience. Ann Thorac Surg 1987; 43: 681-6.
 
14.
Dogan R, Yuksel M, Cetin G, et al. Surgical treatment of hydatid cysts of the lung: report of 1055 patients. Thorax 1989; 44: 192-9.
 
15.
Yalcinkaya I, Er M, Ozbay b, Ugras S. Surgical treatment of hydatid cyst of the lung: review of 30 cases. Eur Respir J 1999; 13:441-4.
 
16.
Sarsam A. Surgery of pulmonary hydatid cyst. Review of 155 cases. J Thorac Cardivasc Surg 1971; 62: 663-8.
 
17.
Aytac A, Yurdakl y, Ikizler C, Olga R, Saylam A. Pulmonary hydatid disease: report of 100 cases. Ann Thorac Surg 1977; 23:145-51.
 
18.
Safioleas M, Misiakos EP, Dosios T, Manti C, Lambrou P, Skalkeas G. Surgical treatment for lung hydatid disease. World J Surg. 1999; 23:1181-5.
 
19.
Horton RJ. Albendazole in treatment of human cystic echinococcosis: 12 years experience. Acta Tropica 1997; 64:79–93.
 
20.
Wen H, Yang WG. Public health importance of cystic echinococcosis in China. Acta Trop 1997; 67:133–45.
 
21.
Nesimi M Eren, Akin E Balci, Şevval Eren. Non-Capitonnage Method for Surgical Treatment of Lung Hydatid Cysts. Asian Cardiovasc Thorac Ann 2005;13:20-23.
 
22.
Soenmez K, Tuereyilmaz Z, Demirogullari B, et al. Hydatid Cysts of the Lung in Childhood. Is Capitonnage Advantageous? Ann Thorac Cardiovasc Surg, 2001;7:11-13.
 
23.
Altug Kosar, Alpay Orki, Gokhan Haciibrahimoglu, Hakan Kiral, Bulent Arman. Effect of capitonnage and cystotomy on outcome of childhood pulmonary hydatid cysts. J Thorac Cardiovasc Surg 2006;132:560-564.
 
24.
Akif Turna, Muhamet Ali Yilmaz, Gokhan Haciibrahimoglu, Cemal Asim Kutulu. Surgical treatment of pulmonary hydatid cysts: is capitonnage necessary? Ann Thoracic Surg 2002; 74:191-195.
 
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