[Echinococcotomy of the upper lobe of the lung in children]

The authors analysed the immediate and late-term results of echinococcectomy of the upper pulmonary lobe in 71 children 3 to 14 years of age conducted by Delbet's (18), A. A. Vishnevsky's (20) and A. T. Pulatov's method (25), 8 children underwent lob--and segmentectomy. Tense cysts were found in 34 and complicated cysts in 25 children. Most of the cysts (37) were localized in the anterior segment of the superior pulmonary lobe. The superior lobes of both lungs were involved with equal frequency. Deformity of the bronchi and pneumosclerosis were encountered in the late periods after Delbet's operation. Residual cavities were formed in 10 out of 20 patients after A. A. Vishnevsky's operation. In 10 patients these operations were complicated by hydro- and pneumothorax at the site of the removed cyst of the superior pulmonary lobe. These complications were due to inadequate drainage of the pleural cavity in the eighth intercostal space. Additional drainage had to be installed in the second intercostal space. The mentioned operations are indicated only in superficial localization of hydatid cysts of small and moderate size in the superior lobe, when the depth and breadth of the residual cavity resulting from echinococcectomy will be no more than 5-6 cm. Creation of an artificial interlobar or intersegmental fissure proved to be the most optimal and effective method of echinococcectomy in large cysts and centrally situated cysts of any size in the upper pulmonary lobe. Fatal outcomes were not encountered.