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Comparison of pulmonary hydatid cysts in children and adults
Fikret Kanat1, Emel Turk, Olgun Kadir Aribas
1Department of Chest Diseases, Meram Medical School of Selcuk University, Konya, Turkey.
Insights
Pulmonary hydatid cysts present differently in children versus adults, with larger cysts and fewer liver involvements seen in pediatric patients. Surgical approaches remain consistent, prioritizing lung-sparing techniques for children.
Area of Science:
- Medical Research
- Pediatric Surgery
- Parasitology
Background:
- Hydatid cysts are parasitic infections caused by Echinococcus tapeworms.
- Pulmonary involvement is a significant manifestation of echinococcosis.
Purpose of the Study:
- To compare clinical features and surgical strategies for pulmonary hydatid cysts in pediatric and adult populations.
- To identify age-related differences in the presentation and management of pulmonary hydatid disease.
Main Methods:
- Retrospective analysis of 134 patients operated on for pulmonary hydatid cysts over 10 years.
- Patients were divided into two groups: children (<18 years) and adults.
- Clinical, radiological, and surgical findings were analyzed for each group.
Main Results:
- Pulmonary hydatid cysts were more frequent in boys than girls among children, with no sex predilection in adults.
- Children had a higher incidence of huge pulmonary cysts (>10 cm) and fewer concomitant hepatic cysts compared to adults.
- Pneumothorax was more common in children, while empyema was more frequent in adults preoperatively.
Conclusions:
- Pulmonary hydatid cysts exhibit distinct characteristics in children, including larger size and lower rates of hepatic involvement.
- Lung-sparing surgical procedures are recommended for children due to their enhanced lung recovery capacity.
- Despite observed clinical differences, the fundamental treatment approach for pulmonary hydatid cysts remains consistent across age groups.
Background:
The purpose of the present study was to compare the clinical features and the surgical approaches of the pulmonary hydatid cysts in children and adults.
Methods:
One hundred and thirty-four patients, operated on for pulmonary hydatid cysts over the last 10 years were retrospectively evaluated in two groups: 39 children who were younger than 18 years old (29%) and 95 adults (71%). The patients in each group were analysed according to their clinical, radiological and surgical findings.
Results:
The frequency of pulmonary hydatid cysts in children was significantly higher in boys (74%) than in girls (26%). However, there was no sex tendency in adults (52% in male vs 48% in women). The sex difference in hydatid cyst frequencies between adults and children was significant (P < 0.05). Among preoperative pleural complications, pneumothorax (15.5%) in children and empyema (11%) in adults were more frequent. The frequency of concomitant hepatic cysts was less in children than in adults (33%vs 79%). Huge pulmonary cysts (=10 cm) were more common in children (31%) than in adults (22%). Cystotomy with capitonnage was the most frequently preferred method in both groups. Postoperative complications developed in six children (16%) and 19 adults (19%), and were more frequent in patients with huge cysts (27%vs 16%). No recurrence was observed in both groups.
Conclusions:
Isolated pulmonary cysts are more common in children than adults. The cysts also tend to be bigger in children than adults. The frequency of concomitant hepatic cysts is less in children. Because of higher lung expansion ability and improvement capacity in children, resection should be avoided and lung saving surgical procedures should be performed. In spite of differences observed in the clinical features it does not change the treatment of pulmonary hydatid cysts in children.
