RESUMO
Introduction: Sporadic cases of lung hydatid cyst is commonin India apart from its endemicity in Mediterranean regionsand other rural areas of developing countries. The patients ofHydatid cyst (HC) of lungs are often diagnosed incidentally.The definitive treatment of such lesions is surgery. Lungpreserving surgery in such cases is generally the preferredtechnique unless there is considerable destruction ofpulmonary parenchyma. Cystotomy and capitonnage arethe two preferred techniques and generally followed. In thisretrospective observational study it was attempted to analyzeoutcomes of cystotomy and capitonnage with regard topostoperative morbidity and mortality.Material and Methods: Between 1st May 2014 and 31stMay 2019, a total of 73 patients with lung Hydatid cyst wererandomly selected from all the hydatid cyst cases operated in atertiary centre and the results and outcome analyzed. Out of 73cases 39 (Group A) were operated by Cystotomy and closureof bronchial opening and 34 (Group B) were operated withCystotomy, closure of bronchial opening and Capitonnage.Results: The mean chest tube removal time for Group A andB was 5.94 ± 3.17 and 3.41 ± 2.61 days respectively. Themean hospital stay was 10.02 ± 4.53 days for group A and7.55 ± 2.66 days for group B. Prolonged air leak (>7days)was found in 15 patients in group A, 14 of which requiredprolonged chest tube drainage and 1 required surgical closure.4 patients in group B had prolonged air leak and all closedwith prolonged chest tube drainage. No abscess formation ormortality was observed in any group in this study. There wasa significant difference between group A and group B withregard to chest tube removal time (P=0.000836), hospital stay(P = 0.047585), and all complications (P= 0.008214).Conclusion: In surgical management of pulmonary Hydatidcyst, capitonnage is superior to cystotomy without capitonnagebecause it reduces morbidity and hospital stay.
RESUMO
Introduction: Primary chest wall tumours are very rare.Chondrosarcoma represents 40% of all chest wall tumours.Wide local excision with tumour free margins has been thegold standard therapy. We evaluated this therapy in relationto various prognostic factors for anticipating the recurrenceof the tumour.Material and methods: 22 cases of Primary chest wallchondrosarcoma was operated upon from 2009 to 2019 withwide local excision with adequate margins. Male constituted77.27% and females 22.73% with the tumour size rangingfrom 5 to 30 cm in size(median 7cm).Results: 19 patients were subjected to lateral chest wallresection. 3 cases underwent partial sternectomies. Resectionwas extended to lungs in 7 cases, diaphragm in 2 cases,vertebral body in 2 cases and clavicle in 2 cases. Reconstructionwas done with polypropylene or titanium mesh and a muscleflap coverage. There was no perioperative mortality. Postoperative complications occurred in 13.6%(n=3). Therewas recurrence in 4 cases within 5 years. 5year disease freesurvival rate was 81.81%.Conclusions: Wide local excision with tumours free marginsstill remains the standard form of therapy. The reconstructiveprocedures have evolved largely to cover the huge defectsfollowing surgery. Post operative adjuvant therapy is guidedby various prognostic factors.