Parenchyma sparing procedures is possible for most pulmonary hydatid disease without recurrence and low complications

A retrospective review of 223 patients (242 operations) of pulmonary hydatid cysts. We analyze and evaluate our experience in the surgical management of this Moroccan endemic disease and concluded that parenchyma-saving must be always used.

In an 8 year period (2002 -2009), 223 patients (242 interventions, 282 pulmonary hydatid cysts) were operated on in our department. There were 166 males and 57 females with a mean age of 45.7 years. The diagnosis was established on the basis of different clinical signs and imaging studies. Surgical approach consisted of a posterolateral thoracotomy in all cases. Different surgical procedures were performed on the pulmonary lesions according to the localization, the size, the complicated or intact cyst and the importance of lung destruction.

Parenchyma-saving were done in 217 patients (238 interventions) cases, including cystectomies (189 cysts), pericystectomies (47cysts) with capitonnage of the cavity in 177 cysts. Radical treatment as lobectomies is used in only 6 cases. Postoperative minors complications occurred in 13 cases (5.4%), including 6 prolonged air leak, 4 pneumonias, one wound infection and two transitory residual cavities. There was no postoperative death. All patients were free of recurrence of thoracic hydatid disease in a follow-up ranging from 3 to 90 months (mean: 49 months).

Hydatid cysts of the lung should be treated before complications. Parenchyma saving is the best procedures for this benign disease; the radical resection must be reserved only for pulmonary destruction.