المعالجة الجراحية للكيسات المائية في الرئة
Abstract
تناول البحث 45 مريضاً لديهم كيسات مائية في الرئة تمت معالجتهم في قسم الجراحة في مشفى الأسد الجامعي في اللاذقية في الفترة بين 1992- 1998 ومراقبتهم لمدة خمس سنوات.
كانت الكيسات المائية في الرئة متعددة في خمس حالات (ثلاثة منها في جهة واحدة واثنتان في الجهتين معاً)، ووحيدة في 40 حالة (18 حالة كانت الكيسات المائية متمزقة وفي 22 حالة كانت الكيسات المائية سليمة).
تمَّ التداخل الجراحي على جميع الكيسات المائية مع الحفاظ قدر الإمكان على النسيج الرئوي. ظهرت المضاعفات في حالتين أي بنسبة 4.4% على شكل ناسور قصبي تمت السيطرة عليه بالعلاج المحافظ. لم تحدث أية حالة نكس أو وفاة.
لقد طبقت المعالجة الدوائية بالميـبندازول أو الألبندازول في جميع الكيسات المائية المتمزقة والعديدة والتي كان هناك شك بتسرب محتوى الكيسة أثناء العمل الجراحي وقد يكون ذلك أحد أسباب انعدام النكس.
في حال الكيسات المائية العديدة والمتوضعة في الرئتين فإنَّنا نفضّل التداخل الجراحي على مرحلتين (كل جهة على حده).
45 patients having hydatid cysts in the lung were treated at the Al-Assad Hospital in the time interval 1992-1998 and observed for five years.
These lung hydatid cysts were multiple in 5 cases (3 of them were unilateral & 2 bilateral), whereas the remaining 40 cases were solitary (18 cysts were ruptured and 22 were intact). All patients underwent conservative surgery to preserve lung parenchyma as much as possible. Two cases (4.4%) suffered postoperatively from bronchial fistulas, which were successfully controlled by conservative managements. No Recurrence or death was recorded.
The treatment with Albendazole or Mebendazole was applied to those ruptured or multiple hydatid cysts, where there was suspicion of Op-field contamination with the cyst content. This kind of treatment may be one of the most important factors of non-Recurrence in our patients. In those patients with bilateral lung hydatid cysts we prefer metachronus (2 steps) surgical interventions.
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