Minimally invasive transthoracotomy–transphrenotomy for concurrent hepatic and pulmonary hydatid disease

Abstract

Combined liver and lung hydatid cysts are rare, but pose a challenge in terms of accessibility. The objective of the study was to find an alternative approach to conventional two-stage posterolateral thoracotomy and laparotomy or single-stage extensive thoracolaparotomy. Twenty-five patients with right lung and liver hydatid disease underwent single-stage anterior minithoracotomy and phrenotomy. Primary diagnostic tools were chest radiography, ultrasonography and serology. The preferred mode of management of hydatid cysts was enucleation and partial or total capitonnage. Thirty-six (13.5 per cent) of 267 patients had concurrent hepatic and pulmonary hydatid cysts. Among the 25 patients who had anterior minithoracotomy and phrenotomy the male : female ratio was 2 : 1. Mean operating time was 75 min. Morbidity was negligible and postoperative recovery was prompt. All of the patients survived. The mean hospital stay was 5.2 days. Overall observations were encouraging. This minimally invasive approach is associated with less morbidity and better cosmesis than conventional procedures. It represents an excellent alternative to other procedures in selected patients.