Zusammenfassung
Die Echinokokkose ist eine seltene Erkrankung in Deutschland, bei der es im Jahre 2016 zu einer Zunahme der Erkrankungsfälle im Rahmen des Flüchtlingsstroms kam. Humanmedizinisch relevant sind 4 Subtypen, wovon die zystische Echinokokkose aufgrund der weltweiten Verbreitung die wichtigste Rolle spielt. Dieser Artikel gibt eine Übersicht über die pulmonale Echinokokkose und fasst die relevanten chirurgischen Aspekte zusammen.
Abstract
Human echinococcosis is a rare zoonotic infection caused by larvae of the tapeworm species Echinococcus. The most relevant two species to humans are Echinococcus multilocularis and the dog tapeworm Echinococcus granulosus. The latter causes cystic echinococcosis, which plays a dominant role in thoracic surgery due to its pulmonal involvement. The parasite develops characteristic hydatic cysts mostly in liver and lung. In 2016 a rise in cases of cystic echinococcosis in Germany was recorded, a probable cause could have been the refugee wave. The infection and advanced stages of the disease does not always cause symptoms and stays asymptomatic. Dry cough, thoracic pain and hemoptysis are uncharacteristic symptoms. Cysts may rupture and void into the bronchial system or thoracic cavity, which can result in empyema. Surgery remains the main therapeutic approach for pulmonary cystic echinococcosis. Surgical therapy includes peri- or endocystectomy, wedge and anatomic resections. Depending on size and localization of hydatid cysts the appropriate surgical technique should be chosen aiming on minimal loss of lung parenchyma. The treatment strategies need to be discussed in an interdisciplinary setting including infectiologists and thoracic or general surgeons. The respective treatment should be carried out in specialized centers due to the low incidence of the disease.
Schlüsselwörter
Echinokokkose - Lungenzyste - Thoraxchirurgie - Zoonose
Key words
echinococcosis - thoracic surgery - hydatid cyst - zoonosis
