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

Treatment of pulmonary hydatid cysts: a single-centre analysis of 872 cases

OBJECTIVES

The objective of this study was to investigate the importance of pulmonary parenchyma preservation, the results of cystotomy and the capitonnage technique and the efficacy of postoperative albendazole treatment.

METHODS

A retrospective study was conducted at a single centre between 2000 and 2024, encompassing 872 consecutive patients with pulmonary hydatid cysts.

RESULTS

Of the cases studied, 394 (45.2%) were female and 478 (54.8%) were male, with a mean age of 26.8 ± 19.7 years (range: 2-86 years). Isolated lung involvement was observed in 553 (63.4%) cases. In general, a single hydatid cyst was detected in 665 (76.3%) patients, and 466 (53.4%) of these had isolated lung involvement. In 452 cases (51.8%), only the right lung was affected, whereas 294 (33.7%) had left lung involvement, and 126 (14.5%) had bilateral lung involvement. An operation was performed in 807 (92.5%) cases. Cystotomy and capitonnage were performed in 782 (89.7%) patients. Thoracoscopic wedge resection was performed in 13 cases (1.5%), cystotomy alone in 5 cases (0.6%), lobectomy in 5 cases (0.6%) and enucleation with capitonnage in 2 cases (0.2%). Postoperative complications included atelectasis in 45 cases (5.6%), prolonged air leak in 8 cases (1.0%), empyema in 6 cases (0.7%), wound infection in 3 cases (0.4%) and bleeding in 2 cases (0.2%). Recurrence was observed in 4 (0.5%) surgically treated cases, and 1 case (0.1%) resulted in death in the postoperative period.

CONCLUSIONS

The management of pulmonary hydatid cysts with cystotomy and capitonnage is feasible in the majority of patients and results in acceptable success and complication rates. Administration of albendazole postoperatively has been shown to be an effective method of preventing recurrence.