I read the article in your journal by Öncel et al.[1] with interest. I would like to make a few comments for the authors.

They have detailed their “minimally-invasive” surgical approach, and reported a mean hospital stay of 7.5 days, with a complication rate of 68.4% (13 of 19 patients). For such defined procedure, both results seemed a little above of given in the recent literature;[2] regardless of the size of the treated cysts.[3] Moreover, information on mean duration of the operation would have given an idea on the feasibility of the procedure.

Additionally, no information was given on use of preoperative or postoperative cystic echinococcosisspecific antibodies, which have been shown to be highly diagnostic and also prognostic for recurrence.[4]

Since the cysts are called as “giant”, the readers may also question the coexistence of any extrathoracic cysts, which is not an infrequent entity for hydatidosis. The calculation mistake of total number of patients (13 vs. 19 described in the text), along with the percentages in Table 1 are thought to be simple typos.

Finally, to conclude a procedure to be highly effective and safe, 30.4% prolonged air leak, 68.4% of total postoperative complication rate, and hospital stay for one week may be uncomforting for the readers.

I would like to congratulate and thank the authors for sharing their new technique and experience with us.

Table 1: Location of cysts in lungs

Declaration of conflicting interests
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding
The authors received no financial support for the research and/or authorship of this article.

REFERENCES
1. Öncel M, Sadi SG, Tezcan B, Şua S, Döngel İ. Parenchymapreserving and minimally invasive thoracotomy technique in giant pulmonary hydatid cysts. Turk Gogus Kalp Dama 2015;23:88-91.

2. Alpay L, Lacin T, Atinkaya C, Kıral H, Demir M, Baysungur V, et al. Video-assisted thoracoscopic removal of pulmonary hydatid cysts. Eur J Cardiothorac Surg 2012;42:971-5.

3. Ürek Ş, Coşgun T, Alpay L, Akyıl M, Mısırlıoğlu A, Tezel Ç. Pulmoner kist hidatik olgularında kistlerin boyutları ve sayılarının önemi. J Kartal Tr 2013;24:13-8.

4. Tenguria RK, Naik MI. Annals of Parasitology 2014;60:297- 303.

Author’s Reply
Dear editor,

The counts and ratios of complications did not prolong the time of hospitalization in most of the thoracic operations. Therefore, we do not think that mentioning about complications did not make the article less interesting. Also, most of the complications were treated before discharging. These complications were not significant to indicate in the article.

About the mismatch of the number of patients, we think there was a mistake in the printing of the journal. The table, which we sent in the revised file of our article in October 2013, is totally different from the table of the printed article. The original table is still in submission file.

We did not study echinonococcus specific antibody tests in the patients who underwent surgery. Radiological imaging is more beneficial from blood tests for diagnosis. Also, for giant cysts, positive or negative blood tests do not change the treatment.

Correspondence: Murat Öncel, M.D. Selçuk Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, 42131 Selçuklu, Konya, Turkey.
Tel: +90 535 - 223 40 68 e-mail: moncel01@hotmail.com