[Surgical treatment of lung hydatid cysts]

Lungs represent the econd most common localization of hydatidosis, after liver. The current treatment for pulmonary hydatid cyst (PHC) is complete excision with maximum preservation of lung tissue. The authors emphasize the particularities of diagnosis and surgical treatment of PHC.

A clinical retrospective study was carried out on a series of 247 cases with PHC, admitted in the Thoracic Surgery Department of Pneumology Hospital of Iaşi between 1999 and 2007. Data regarding the clinical picture, imagistical findings and surgical treatment were collected from the medical files and reviewed.

There were 162 men and 85 women, aged between 11 and 78 years. Of these, 134 patients had uncomplicated cysts and 113 had complicated forms. The cysts were located in the right lung in 115 cases (46.5%), the left lung in 98 cases (39.5%) and bilaterally in 34 cases (14%). Liver cysts were associated in 28 cases (11.3%) cases. The surgical procedures employed were: Dor in 118(47.5%) cases, Posadas in 64 (26%) cases, Geroulanos in 5 cases and ideal cystectomy in 14 cases. Pulmonary resection was used in 46 cases (18.5%), including 16 wedge resections, 27 lobectomies and 3 pneumonectomies. Medical parasiticide (Albendazole, 800 mg per day) was used postoperatively. The outcome was fatal in one patient (0.41%), mainly due to associated pathology. In our series, the overall incidence of complications was 7.7%, these consisting of: anaphyfilaxis (3 cases), hemothorax (2 cases), pneumothorax (2 cases), prolonged air leak in 5 cases (including a bronchial stump insufficiency) and atelectasis (5 cases).

Surgery is the mainstay of the treatment of PHC and the operative technique must be adapted to each individual case.