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A 10-Year Retrospective Study: To Evaluate the Anesthetic and Surgical Management for Pulmonary Hydatid Cyst in
E Dity Nissi Roja1, Haarini Sundar2, Loganathan Arun Kumar2
1Department of Anaesthesiology, Christian Medical College, Vellore, India.
Insights
Managing pediatric pulmonary hydatid disease (PH) requires careful anesthetic and surgical planning. One lung ventilation (OLV) is crucial for minimizing spillage and complications, especially with ruptured cysts.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Parasitology
Background:
- Pulmonary hydatid disease (PH) is a significant pediatric health concern in endemic areas.
- Anesthetic and surgical management of PH is complex, with ruptured cysts posing risks like airway obstruction and anaphylaxis.
Purpose of the Study:
- To evaluate the anesthetic and surgical management of pediatric pulmonary hydatid disease.
- To identify factors influencing intraoperative complications and outcomes.
Main Methods:
- A 10-year retrospective cohort study (2012-2022) of children (≤18 years) undergoing surgery for PH.
- Data collected from medical records, operative notes, and imaging.
- Analysis of anesthetic techniques, surgical procedures, and complications.
Main Results:
- 28 children with PH underwent 31 procedures; 12 cases involved ruptured cysts.
- One lung ventilation (OLV) was used in 96% of cases, with complications like desaturation (75%) and bradycardia (29%).
- Major perioperative events occurred in children with ruptured cysts; prolonged OLV and hospital stay were noted in complicated cases.
Conclusions:
- One lung ventilation (OLV) is essential for minimizing spillage and facilitating surgical management in pediatric PH.
- Intraoperative complications were more frequent in cases with bilateral PH.
- Prolonged OLV duration and hospital stay were associated with complicated pulmonary hydatid cysts.
Background:
Pulmonary hydatid disease (PH) remains a significant health challenge in children from endemic regions. The anesthetic and surgical management of PH is complex, particularly in the presence of ruptured cysts, which pose risks such as airway obstruction and anaphylaxis.
Methods:
A 10-year retrospective cohort study was conducted on children ≤ 18 years undergoing surgery for PH at our tertiary care center between January 2012 and December 2022. Data were collected from medical records, operative notes, and imaging reports.
Results:
There were 37 cases with diagnosis of pulmonary hydatid disease in last decade, we have included 28 children with complete records. Three had bilateral disease, totaling 31 procedures. Ruptured cysts were noted in 12 cases. Common symptoms included cough, fever, and hemoptysis. One lung ventilation (OLV) was achieved in 96% of cases with DLT (45%), Arndt blocker (33%) and Fogarty blocker (13%) commonly used. Complications included desaturation (75%), transient bradycardia (29%), and three major perioperative events, all in children with ruptured cysts. The mean OLV duration was longer in complicated cases (3.42 vs. 2.3 h, p = 0.019). Postoperative air leaks occurred in 10 children, with three requiring re-surgery. All patients were extubated on-table, with mean length of stay of 7 days and no long-term morbidity or mortality.
Conclusion:
OLV is critical in minimizing spillage and facilitating surgical management in pediatric PH. The incidence of intraoperative complications was higher in those with bilateral Pulmonary hydatid disease. The duration of One Lung Ventilation (OLV) and hospital stay was prolonged in those with complicated pulmonary hydatid cyst.
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