Morbidity and Mortality Risk Factors for Lung Hydatidosis Surgery: Over 30 Years' Experience Review

Lung hydatidosis (LH) is still an endemic pathology. Different published surgical series have reported variable numbers of patients, but few have studied the morbidity- and mortality-associated risk factors.

Through a retrospective with a descriptive and analytical aim study, performed from January 1987 to December 2020, we reported all patients who underwent operations for LH, regardless of the cyst locations, numbers, and aspects. We excluded patients who were not operated on, patients with extrapulmonary hydatidosis, and those with a cystic pathology other than LH.

Operations for LH were performed in 1169 patients, with a total of 1288 interventions and a median age of 20 years (semi-interquartile range [SIQR],11.5; 2-89 years). There were a total of 1951 cysts, with a median of 1 cyst (SIQR,0; 1-37 cysts) and a median size of 60 mm (SIQR,20; 10-250 mm). Forty percent were complicated. Conservative surgery was performed on most patients, and anatomical resection was required in 23 patients (1.8%). The median number of bronchial fistulas was 3 (SIQR,1; 0-16 fistulas). Decortication was necessary for 94 patients (7.3%). The morbidity rate was 25%, and mortality was 0.4%. Fever, pleural effusion, and associated decortication were correlated morbidity and mortality risk factors. Other morbidity factors were identified, including nonprotection of the surgical field, a cyst size ≥55 mm, and ≥3 bronchial fistulas. Mortality factors were determined, such as postoperative occurrence of septic shock, hemorrhage, and respiratory distress.

The earlier we operate on LH patients (before complications set in) and identify the different associated risk factors, the better the prognosis of curative surgery is.