Treatment approach in bilateral pulmonary hydatid cysts: analysis of 107 consecutive cases

OBJECTIVE

Bilateral pulmonary involvement is observed in around 14% of cases of pulmonary hydatid cysts and the treatment can be challenging. This study evaluates the clinical characteristics and treatment strategies used for cases of bilateral pulmonary hydatid cysts.

MATERIALS AND METHODS

A retrospective examination was conducted on 107 consecutive cases of bilateral pulmonary hydatid cysts treated in our clinic between January 2003 and December 2023.

RESULTS

Out of the 107 cases analyzed, 57 (53.3%) were male and 50 (46.7%) were female. Surgical intervention was performed for pulmonary hydatid cysts in 92 cases (86.0%), while medical treatment was prescribed for the remaining 15 cases (14.0%). Bilateral thoracotomies were consecutively conducted in 77 cases; in 11 cases, thoracotomy was carried out on one side and contralateral hydatid cysts were treated medically. Three cases underwent sternotomy, and one underwent bilateral thoracotomy during a single session. One case experienced postoperative hemorrhage, three cases had prolonged air leakage, two cases had empyema, one case had a wound infection, and one case had a recurrence of hydatid cyst. For bilaterally operated cases, albendazole treatment commenced after the second operation and was carried out in two 15-day cycles. Patients who declined, or were not eligible for surgery, were treated with albendazole for an extended period.

CONCLUSIONS

Consecutive bilateral thoracotomy, followed by two cycles of albendazole therapy, is a highly effective treatment for patients with bilateral pulmonary hydatid cysts. In cases with widespread involvement, ruptured small cysts, or serious comorbidities, long-term medical treatment including albendazole administration may be applied.

Doubling time in pulmonary and hepatic hydatid cysts

BACKGROUND

This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver. Background: This study aims to investigate whether the concept of doubling time in hydatid cysts differs according to different parameters such as age, sex, and whether the cyst is located in the lung or liver.

METHODS

Between January 2012 and August 2023, a total of 138 hydatid cysts were retrospectively analyzed. There were 55 pulmonary (32 males, 23 females; mean age: 25.6±23.8 years; range, 2 to 77 years) and 83 hepatic hydatid cyst patients (32 males, 51 females; mean age: 31.1±22.8 years; range, 3 to 75 years).

RESULTS

The mean doubling times for pulmonary and hepatic hydatid cysts were 73.4±41.8 and 172.6±108.8 days, respectively (p<0.001). When children (≤18 years old) and adult cases were compared for pulmonary hydatid cysts, the mean doubling times were 61.1±17.6 and 87.1±55.3 days, respectively (p=0.119), and for hepatic hydatid cysts, 110.6±48.4 and 215.6±118.3 days, respectively (p<0.001). While comparing male and female cases, the mean doubling time for pulmonary hydatid cysts was 77.6±32.2 and 67.6±52.6 days, respectively (p=0.018), while for hepatic hydatid cysts, it was 192.0±111.7 and 160.4±106.2 days, respectively (p=0.250).

CONCLUSION

The doubling time seems to be approximately 10 weeks in the lung and approximately 25 weeks in the liver. Hydatid cysts grow faster in children than adults in both the lungs and liver.