Surgical approach of pulmonary hydatidosis in childhood

Abstract

To review the results of different surgical treatment in hydatid disease of the lung in paediatric patients. A total of 102 children with pulmonary hydatid cysts were treated at the our clinic in the period from 1990 to 2001. There were 59 boys and 43 girls and their age ranged from 4 to 16 years (mean 10.2). Chest radiography, computed tomography and abdominal ultrasonography were the most commonly used diagnostic techniques. The cysts were located in the right lung in 68 patients (66.6%), in the left lung in 30 patients (29.4%), in both lungs in four patients (3.9%). Concomitant liver cyst hydatid was also detected in 12 patients that were located at right lung, and two patients with bilateral lung involvement. All cases were managed surgically. Of 14 cases with concomitant liver and intrathoracic hydatid cysts, right thoracophrenotomy was performed in 12, median sternotomy in one, and phrenotomy in other. Partial cystectomy and capitonnage were the most commonly used surgical methods. Post-operative complication was seen in 10 (9.8%) patients. Infection at the incision site occurred in four patients and air leakage in three. Complications of capitonnage were seen in three patients. One patient (1%) died at fourth post-operative day due to sepsis. Parenchyma protective operations should be performed especially in children living in endemic areas because of the possibility of recurrence of the disease in the future. Single stage operations in suitable cases decrease the cost of treatment and make surgical therapy suitable in both children and young adults, by reducing the hospital in-patient time and morbidity.