ABSTRACT
A 35 years male presented with history of pain left chest wall associated with cough, fever and blood in sputum on and off, complaint of pain in abdomen which was dull aching gradually progressive in nature since, 2 months. Radiologically diagnosed to have huge hydatid cysts both in left lung and liver. It is unusual to find such large cysts at multiple sites and organs as in this case. There are reports in the literature of staged management as well as simultaneous management of lung and liver hydatid cysts. Though concomitant cysts in lung and liver may be treated comfortably by one stage surgery. Here both cysts were enucleated in the same sitting by a combined thoracic and abdominal approach (left thoracotomy followed by laparotomy through right subcoastal incision). The technique is safe and results were comparable to two stage surgery. Albendazole treatment in post-operative period helps to prevent recurrence. This report emphasizes that surgical intervention for hydatid cysts at multiple sites done in a single stage is safe, lessens the financial burden and hospital stay by avoiding multiple surgeries and anaesthesia.
ABSTRACT
To date, the efficacy of radical surgery (RS) versus conservative surgery (CS) for liver hydatid cysts (LHC) remains controversial. This meta-analysis was conducted to compare the two interventions. PubMed, Embase, and Web of Science were searched from their inceptions until June 2016. Meta-analysis was performed using STATA 12.0 software. We identified 19 eligible studies from 10 countries by retrieval. In total, 1853 LHC patients who received RS were compared with 2274 patients treated by CS. The risk of postoperative overall complication, biliary fistula, and recurrence was significantly lower, and operation time was significantly longer in the RS group. However, no statistically significant differences were found in terms of mortality risk and the duration of hospital stay between RS and CS. No significant publication biases were observed in all the above analyses. In conclusion, RS reduces the rates of postoperative complications and recurrence, whereas no trend toward such a reduction in mortality was observed in LHC patients.