Conservative Surgical Management for Pulmonary Hydatid Cyst: Analysis and Outcome of 148 Cases

Abstract

Background. Hydatid cyst (HC) disease is endemic in many developing countries, like Yemen, Egypt, and Saudi Arabia, especially in the rural regions. The disease has a variable clinical courses and even might be asymptomatic for many years. Objectives. In giant and large pulmonary hydatid cysts, pulmonary resection is the usual method of surgical treatment. In this study, we aimed to evaluate the lung conservative surgery in treatment of cases with giant and large hydatid lung cysts, as an effective method of management. Patients and Methods. Between January 2009 and August 2014, a total of 148 patients with pulmonary hydatid cysts were operated and their data was reviewed retrospectively and analyzed. Out of these cases, 52 (35.14%) cysts with more than 10 cm in diameter and 36 (24.32%) cysts with 5–9 cm were regarded as giant and large hydatid lung cysts, respectively. The small cysts less than 5 cm were presented in 8 (5.4%) cases only; other cases had ruptured cysts. Preservation of the lung tissues during surgery by cystotomy and Capitonnage was our conservative surgical methods of choice. Results. Eight patients developed bronchopleural fistula (BPF); of them, 4 BPFs have healed with chest tube and physiotherapy, but in the other 4 patients reoperation was done for the closure of persistent BPF. No mortality was observed in the present study. Conclusion. We conclude that conservative surgical procedure can achieve complete removal of the pulmonary hydatid cyst. Enucleation of the intact huge cysts is safe. Careful and secured closure of the bronchial communication should be done by purse string or figure-of-8 sutures, with or without Teflon pledgets. These simple procedures are safe, reliable, and successful.

Hydatid disease among adults and children: it is time to worry!

“…Despite preventive measures, the hydatid disease remained relatively high in our region and continued to be endemic. It's a multisystem disease that affects commonly the liver in adults and the lungs in children (2,4). Concomitant involvement of the liver and the lungs were reported in 16-23.1% of the cases (2), which was similar to our results.…”

“…When the HC get enlarged, clinical symptoms begin. Cough, dyspnea, chest pain and hemoptysis are common presentation of pulmonary HC (4,11). Hepatic HC remains asymptomatic for a while, then, as it growths, it can cause abdominal pain and discomfort.…”

“…Less commonly, others sites are involved. However, the most common affected site in children is the lungs (2,4). The hydatid cyst (HC) is asymptomatic and as it growths, it might cause compression of adjacent organ and lead to complications which explains clinical symptoms.…”

Single-center experience in the surgical treatment of combined lung Echinococcosis

“…Cystostomy includes aspiration of cyst fluid and eliminating of growing membrane (Barrett’s techniques). 16 Capitonage is complete closing of the cyst by suturing the cyst’s wall. The method provides extra strength of lung parenchyma and prevents subsequent dissemination through air and formation of empyema.…”

Surgical management of pulmonary hydatid cysts in children in KwaZulu-Natal Province, South Africa

“…South America, Australia, India, the Middle East, sub-Saharan Africa and Mediterranean countries. [1][2][3] South Africa (SA) has a large rural community where livestock subsistence farming is common. Hydatid disease is caused by a parasite, Echinococcus granulosus, that accidentally infects humans.…”