[Surgical tactics and surgical techniques in echinococcal cysts in the lung in children]

The differentiated surgical approach to hydatid lung cysts and the operative techniques used in 343 children treated in the Department of Pediatric Surgery over 24 years (1975-1998) are presented. The left lung is involved in 143 children (41.7%), the right--in 155 (45.2%), whereas in 45 cases (13.1%) it is a matter of bilateral location. Infectious complications occur in 198 cases (57.7%). In compliance with the anatomical location, size, extent and accompanying complications two surgical procedures are mainly used: 1) Total removal of the cyst without disrupting its continuity (closed echinococcotomy) in 19 per cent, and 2) Evacuation of the cyst fluid, as well as the germinative membrane, followed by appropriate management of the residual fibrous cavity in 81 per cent of cysts. Echinococcotomy with suture obliteration of the residual cavity in conjunction with sparing lung resection, yielding superior functional results postoperatively, is the method of choice.