Surgery for thoracic hydatid disease: a North American experience

Area of Science:

• Thoracic Surgery
• Parasitology
• Infectious Diseases

Background:

• Hydatid cysts in the thorax are rare, particularly in North America.
• Echinococcosis, caused by tapeworms, can affect various organs, including the lungs and liver.
• Previous studies show varying prevalence and outcomes of thoracic hydatid disease.

Purpose of the Study:

• To review the clinical course and outcomes of patients with thoracic hydatid cysts.
• To assess the surgical management and long-term follow-up of this rare condition.
• To determine the prevalence and characteristics of thoracic hydatid disease in northeastern North America.

Main Methods:

• Retrospective review of 20 patients with 22 thoracic hydatid cysts operated on between 1957 and 1984.
• Analysis of clinical data, surgical procedures, complications, and long-term follow-up (up to 27 years).
• Evaluation of cyst characteristics, including rupture status and organ of origin.

Main Results:

• Most patients were from Mediterranean regions; 5 were native Canadians.
• 14 patients had primary lung cysts, while others had infected liver cysts with thoracic extension.
• Ruptured cysts (13/22) and infected hepatic cysts involving the lung were more prevalent than in other series, necessitating aggressive surgical treatment (wedge resections, lobectomies).
• No early deaths occurred; perioperative complications were infrequent.
• One late death occurred due to massive echinococcosis and sepsis.
• No evidence of thoracic recurrence in long-term survivors, with one exception of a prior recurrence.

Conclusions:

• Thoracic hydatid disease is rare in northeastern North America.
• A higher prevalence of ruptured and infected hepatic cysts necessitates aggressive surgical management.
• Despite complex cases, morbidity was low, and long-term recurrence was uncommon.