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ORIGINAL ARTICLE
Outcome of the Capitonnage and non-
Capitonnage Procedure for Pulmonary
Hydatid Cyst Surgery
Md. Shamsul Alam 2 , GM Akbar Chowdhury 3 AKM Razzaque 4 , Md. Kamrul Alam 5
Manabendra Biswas 6 , AKM Akramul Haque 7 , Md. Mofizur Rahman Mia 8 , A.A.
Kibria 5 , Md. Kamrul Islam 5 , Md. Shahedur Rahman Chowdhury 5 , Md. Akhter
Hamid 6
Introduction:
Pulmonary hydatid cyst is a zoonotic disease with worldwide distribution. Most individuals
who contract this parasite are young and majority of patients are less than 40 years of age 1 .
In man, hydatid disease affects the liver in 50 to 60% the lung in 18 to 35% of cases. The
Pulmonary hydatid disease affects the rightlung in 60% of cases, 30% exhibit multiple
pulmonary cysts, 20% bilateral cysts and 60% are located in the lower lobes 2 .
Small simple cyst located peripherally usually remains asymptomatic. Symptomatic patients
may present with chest pain, cough, haemoptysis, dyspnea, fever and respiratory distress 1 .
Surgical methods for dealing with pulmonary hy datid cysts include enucleation of intact
cysts. Closure of the bronchial opening done by muscle pledgeted suture or by simple 3-0 silk.
After bronchial opening closure the remaining cavity can be obliterated by capitonnage.
Capitonnage is the procedure by which residual cavity is obliterated by imbricating sutures
form with in (separate purse String sutures that is places into the cavity from deepest level
to the surface). The impact of capitonnage on surgical out come is unknown and the
technique continues to be performed at the choice of the surgeon 3 . Some surgeons preferred
to keep the cavity open after closing of the bronchial opening. Post-operative complication are
[Chest & Heart Journal 2009; 33(2) : 87-93]
pronged air leak (air leak>7 days), empyema and wound infection 3 .
Hypothesis
Enucleation of pulmonary hydatid cyst without capitonnage yields better surgical outcome.
Aims and objectives
To compare the outcome of the capitonnage and non-capitonnage procedure for pulonary
hydatid cyst surgery.
Surgical treatment of pulmonary hydatid cyst:
The current treatment of hydatid disease of the lung is complete excision of the disease
process with maximum preservation of lung tissue 4 .
Hucubrahimoglu et al 5
in his series of 91 patients, enucleation plus capitonnage was the