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Experience with video-assisted thoracoscopic removal of pulmonary hydatid cysts in children
Sandesh V Parelkar1, Rahul K Gupta, Hemanshi Shah
1Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai 400012, India.
Insights
This study highlights the successful surgical removal of pulmonary hydatid disease in pediatric patients using video-assisted thoracoscopy. All patients recovered well, demonstrating the efficacy of this minimally invasive approach for lung hydatid cysts.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Parasitology
Background:
- Pulmonary hydatid disease is a significant parasitic infection affecting the lungs, particularly prevalent in endemic regions like India.
- Early diagnosis and effective treatment are crucial for managing pediatric lung hydatid cysts to prevent complications.
Purpose of the Study:
- To evaluate the efficacy and safety of video-assisted thoracoscopic surgery (VATS) for the management of pulmonary hydatid disease in pediatric patients.
- To assess the outcomes and recovery patterns following VATS in this specific patient cohort.
Main Methods:
- A series of 5 pediatric patients diagnosed with pulmonary hydatid disease via clinical and radiological findings (X-ray chest, CT chest).
- All patients received oral albendazole, with VATS performed under simple endotracheal intubation and CO2 insufflation.
- Surgical procedures included complete thoracoscopic removal or conversion to open thoracotomy when necessary.
Main Results:
- Complete thoracoscopic removal was achieved in 3 out of 5 patients; 2 required conversion to open thoracotomy.
- Most patients demonstrated rapid recovery, with an average procedure duration of 150 minutes and a mean hospital stay of 4.5 days.
- Histopathology confirmed hydatid cysts in all cases, and all patients were asymptomatic at a 6-month follow-up.
Conclusions:
- Video-assisted thoracoscopic surgery is a viable and effective treatment option for pediatric pulmonary hydatid disease.
- VATS offers a minimally invasive approach with generally good outcomes and rapid recovery, though conversion to open surgery may be required in some cases.
Abstract:
Pulmonary hydatid disease is prevalent in many parts of world including India. In our small series of 5 pediatric patients, all patients were diagnosed with clinical and radiological findings on plain X-ray chest and CT (Computed Tomography) chest. All of them received oral albendazole 10 mg/kg/day soon after diagnosis except in one patient in which preoperative differential diagnosis was bronchogenic cyst and lung abscess (case 4). All underwent video assisted thoracoscopy. Simple endotracheal intubation was utilized in all cases along with CO(2) insufflation. Complete thoracoscopic removal was successful in 3 cases, while conversion to open thoracotomy was required in 2 cases. All of them showed rapid recovery except for one patient in whom prolonged intercostal drainage was present for 2 weeks. The average duration of procedure was 150 minutes and average length of hospital stay was 4.5 days except case 2, which was discharged on day 15 due to prolonged air leak. Histopathology in all cases was suggestive of hydatid cyst. At mean follow up of 6 months, all patients are asymptomatic and doing well.
