Thoracotomy versus triportal VATS in pulmonary hydatid cyst surgery: A single center experience

Abstract

OBJECTIVE: The aim of this study was to compare triportal videothoracoscopic thoracic surgery and thoracotomy in pulmonary hydatid cyst surgery to help determine the most appropriate surgical method according to the characteristics of the pulmonary hydatid cyst.

METHODS: The study included 57 patients who underwent thoracotomy and triportal videothoracoscopic thoracic surgery (TVATS) due to lung cystic disease between January 2012 ßand March 2019. The patients were separated into two groups as TVATS and Thoracotomy groups. Statistical comparisons were made of the groups in terms of age, visual analog (VAS) pain score, length of hospital stay, length of surgery, complications, ASA score and cyst features. Probability values less than p = 0.05 were considered significant.

RESULTS: Length of surgery, and length of hospital stay were significantly longer and ASA score, postoperative VAS pain scores, total number of cysts, and cyst sizes were found to be significantly higher in the Thoracotomy Group.There was no significant difference between the groups in respect of age, gender and postoperative complications.

CONCLUSION: Triportal Videothoracoscopic Surgery (TVATS) in the treatment of pulmonary hydatid cyst surgery was seen to be superior to thoracotomy in respect of operation and hospitalization time, and postoperative pain scores. While videothoracoscopic cyst excision and cappitonage can be performed more easily than giant cysts in peripheral and 10 cm cysts, it is more difficult in central and giant cysts. Considering that it may cause bronchopleural fistulae if not done well, it may be appropriate to prefer thoracotomy, especially in giant cysts, until they have sufficient experience with vats.