Surgical treatement of pulmonary hydatid disease in children--a retrospective study

Hydatide disease is endemic in sheep and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Bosnia and Herzegovina. Retrospective appraisal of the pressentation, approach to surgical treatment and outcome of hydatid disease in children at the Clinic for Pediatric Surgery and Clinic for Thoracic Surgery University of Sarajevo Clinics Centre in period between 2000-2008. We surgically treated 72 patients (57 male, 15 female) with a diagnosis of pulmonary hydatid disease with average age of 10.36 +/- 4.28 (range 4 to 18) years. Chest radiographs, computer tomograms and ultrasonography were the main methods of diagnosis. The basic principle of surgery was to preserve lung parenchyme as much as possible. Clinical assessment of the symptoms, plain and lateral chest X-rays and computed tomograms led to the correct diagnosis in 100% (72/72) of patients. Solitary lung cysts were found in 79.17% (57/72) patients. While the remaining were multiple cysts in one or more lobes of one or both lungs. Intact cysts were found in 48 (52.17%) and rupture cysts in 44 (47.83%) cases. Lung preserving surgical intervention were done in all of the patients. There was no mortality. Recurrent hydatid cysts were observed in 2.78% (2/72) patients. Lung preserving surgical interventions are the treatment of choice for pulmonary hydatid cysts in children. Radical surgical procedures such as segmentectomy, lobectomy and pneumonectomy should be avoided as much as possible in children.