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Lung Hydatid and Broncho-Cavitary Communications: Challenges in the Management and Outcome
Nitin Sharma1, Shipra Sharma1, M Amin Memon1
1Department of Paediatric Surgery, DKS PGI and Research Center, Raipur, Chhattisgarh, India.
Background:
The aim was to analyse the challenges and outcomes in operated patients of hydatid lung with broncho-cavitary communications.
Materials And Methods:
The retrospective data between June 2017 and May 2022 were obtained. The number of broncho-cavitary communications was recorded and they were suture repaired using polypropylene. The duration required for repair and the average fall in the SpO 2 were recorded. Those with incomplete data or follow-up were excluded. The outcome parameters considered were number of broncho-cavitary communications, duration of stay, duration of intercostal tube, duration of air leak and requirement of ventilator support.
Results:
A total of 33 patients out of 36 formed the study group. The mean age was 6 years (range 2-18 years). There were 23 right-sided, eight left-sided and two bilateral cysts. Broncho-cavitary communications were seen in 33 patients. The average number of communications was 3 (range: 2-8). The average duration required to suture close the communications was 30 s (range 20-180 s). The average fall in the SpO 2 was 40% (range 20%-74%). The main challenge was rapid identification of communications and prompt repair. The mean duration of surgery was 2.15 h (range 1.45-3.15 h). Ventilator support in the post-operative period was required in four patients. The average duration of intercostal tube drainage required was 7 days (range: 6-14 days). The average duration of hospital stay was 14 days (range 12-34 days). All the communications were repaired using Prolene 3-0 sutures. None of the patients was operated with a double-lumen endobronchial tube.
Conclusion:
Broncho-cavitary communication in hydatid cyst is associated with an operative challenge due to sudden air leak. These patients require judicious management.
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