# Thoracoscopic capitonnage for pulmonary hydatid cysts: the predictors of prolonged air leak

## TL;DR

This study examines why some patients experience prolonged air leaks after a surgical procedure for lung cysts, finding that lung collapse is a key factor.

## Contribution

The study identifies collapse consolidation as a predictor of prolonged air leak after thoracoscopic capitonnage for pulmonary hydatid cysts.

## Key findings

- All patients had residual cavities after the procedure, but this was not significantly linked to prolonged air leaks.
- Collapse consolidation in the affected lung lobe was strongly associated with prolonged air leaks.
- Ruptured cysts were more common in patients who experienced prolonged air leaks.

## Abstract

Pulmonary hydatid cysts (PHCs) represent a serious zoonotic disease that requires prompt intervention because of their potential complications. Capitonnage is one of the most common performed techniques; however, controversies surround its role in managing PHCs. The present study aims to evaluate lung parenchyma using computed tomography (CT) scans 48 h after capitonnage of PHCs performed via VATS.

Fifty-six patients with suspected PHCs on CT scans between 2021 and 2023 were included, while we excluded patients with risk factors for prolonged air leak (PAL), patients with other organ involvement, those presenting with emergency conditions, and those younger than 12 years old.

The CT scans revealed residual cavities in all 56 patients (100%), ranging in size from 2 to 12 cm. There was a collapse consolidation involving the affected lobe in all of the cases (100%). Eight patients (14%) experienced PAL; one patient (12.5%) had an intact cyst, while the other seven cases (87.5%) had ruptured cysts (p-value <0.001). There was no significant difference in cavity size between patients who developed PAL and those without PAL (p-value: 0.07), while patients with larger areas of consolidation tended to have PAL (p-value: 0.001).

The PAL is more likely caused by collapse consolidation rather than residual cavities left after the procedure. Additionally, ruptured cysts can significantly contribute to the complication of PAL.

Infographic summarizing findings from a study on 56 patients with pulmonary hydatid cysts (PHCs) who underwent capitonnage via video-assisted thoracoscopic surgery (VATS). CT scans performed 48 hours post-procedure revealed that prolonged air leaks (PAL) were more commonly due to collapse consolidation rather than residual cavities. Ruptured cysts were also identified as a contributing factor to PAL. A CT image on the right shows axial chest section with collapse consolidation in the right lower lobe. Key terms and abbreviations are defined at the bottom of the image.