Abstract:
Purposes The aim of this study was to assess the relationship
between the pulmonary hydatid cyst size and the
clinical presentation, surgical approach, and postoperative
outcome. We review the problems encountered in treating
large pulmonary hydatid cysts and highlight the risks
associated with the rupture of the cyst and a delay of the
surgical treatment.
Methods The medical records of 169 patients surgically
treated for lung hydatid cysts were reviewed. Patients were
divided into two groups based on cyst size: group 1
(n = 128) with small (\10 cm) cysts and group 2 (n = 41)
with giant (C10 cm) cysts. Data related to symptoms,
preoperative complications, surgical procedures performed
and postoperative morbidity were analyzed and compared.
Results In both groups, the most common symptom was
chest pain, followed by dyspnea and cough, respectively.
There were no differences between the two groups with
respect to cyst-associated parenchymal or pleural complications
before surgery (p = 0.80). In the large majority of
cases, the surgical treatment was cystotomy, removal of the
cystic membrane and capitonnage. Wedge resection was
performed in nine patients in total (seven in group 1, two in
group 2) and one patient in group 2 required a lobectomy.
Decortication was required significantly more frequently in
group 2 than in group 1 (p = 0.001). Sixteen patients in
group 1 and 10 patients in group 2 developed postoperative
complications (p = 0.19). There was no peri or postoperative
mortality. There was no difference between the
groups with respect to the duration of hospitalization
(p = 0.17). Two patients with complicated hydatid cysts in
group 1 had recurrent lesions during follow-up, whereas
there was no recurrence in group 2.
Conclusion All pulmonary hydatid cysts should be surgically
treated as soon as possible after their diagnosis in
order to avoid complications. Most of these lesions,
regardless of size, can be surgically managed with procedures
that preserve the maximal lung parenchyma and yield
excellent outcomes.
