Pulmonary echinococcosis (hydatidosis) in children: Results of surgical treatment

Abstract

From 1986–1996, 33 children with 49 pulmonary hydatid cysts underwent surgical treatment in Vienna and Istanbul. Cysts were unilateral in 28 and bilateral in 5 cases; unruptured cysts (URC) were diagnosed in 19 patients, and 14 children presented with ruptured cysts (RC). Ten patients had cysts in other organs (liver, spleen, central nervous system) in addition to pulmonary cysts. Diagnosis was primarily based on chest X‐ray and computed tomography scan. In Austrian children, a new combination of serological tests was used successfully (71% positive). The standard surgical procedure was cystotomy followed by capitonnage. The main postoperative complications were fever and wound infection. There were two recurrences after a mean follow‐up of 4.8 years, and one patient died because of multiple organ involvement. We conclude that the therapy of choice in pediatric pulmonary hydatidosis is complete surgical elimination of the cyst by cystotomy and capitonnage, whereas more extended resections should be avoided. Ideally, benzimidazole treatment should be combined with surgery. New serological tests can improve diagnostic accuracy. Pediatr Pulmonol. 1999; 27:336–340. © 1999 Wiley‐Liss, Inc.

Conservative Surgical Treatment of Pulmonary Hydatid Disease in Children: An Analysis of 35 Cases

“…This technique is preferred by many clinics and is especially justified in children. 3,[9][10][11][12] Because the lung parenchyma has a great capacity for expansion, it is possible to leave a small area of parenchyma after the cyst is removed. We do not recommend enucleation and cystectomy because enucleation has a higher risk of contamination, and cystectomy increases the risk of air leaks and postoperative bleeding.…”

“…We performed cystotomy and capitonnage in 33 (94%) of the 35 patients in this series. Conservative surgery was performed in about 86.8% of 1596 patients, [1][2][3]10,12,14 but in only about 48.0% of another series of 245 patients because resection was preferred by the surgeons for all complicated and heavily infected cysts. 4,15,16 On the other hand, Kahraman et al 14 recently reported performing cystotomy and capitonnage for 40 of 42 (95.2%) patients with ruptured and complicated cysts.…”

Diagnosis and treatment approaches of the lung hydatid cysts in childhood

“…Due to the delay in the diagnosis, the cyst were detected as larger sized cysts [7,13]. In our patient group, the cysts was 5 cm and bigger in diameter in 23 (69.7%) cases.…”

Our approach to the treatment of pulmonary hydatid cyst

“…gana göre semptomlar ortaya çıkar. Bir yılda kistte 1 veya 2 cm çap artışı olabileceği bildirilmiştir (4,11,12) . Hidatik kistlerin çoğunun çocukluk çağında edinildiği fakat kistin yavaş büyüme özelliğinden dolayı 3.-4. dekadlara kadar tanı konulamadığı bildirilmektedir (12) .…”