Single-stage versus two-stage surgery of pulmonary and hepatic hydatid cysts

Abstract

IntroductionConcomitant lung and liver hydatid cyst is a rare condition. Most surgeons agree that both sites should be resected in one-time surgery.AimWe present a case series of hepatic and pulmonary hydatid cyst treated in one-stage surgery (OSS) compared with patients who underwent two-stage surgery (TSS).Material and methodsThis retrospective study included 47 patients separated into two groups (33 TSS and 14 OSS) between 2008 and 2019. Data on clinical symptoms, sites, radiological features, techniques, postoperative complications, mean hospital stay and outcome were analyzed separately for TSS and OSS procedures.ResultsA total of 33 patients who underwent TSS (70.2%) were compared to 14 patients operated on by OSS (29.8%). No significant differences were found between groups for age (45.3 vs. 42.7, p = 0.45), sex (male: 57.6% vs. 64.2%) and socio-geographic status (urban: 72.7% vs. 78.6%). But there were more postoperative complications (24.3% vs. 14.3%, p = 0.036) in the TSS group, and operative duration (154 minutes vs. 122 minutes, p = 0.047), postoperative hospital stay (13.8 days vs. 8.7 days, p = 0.022), and interruption of activities and work (56 days vs. 31 days, p = 0.045) were longer in the TSS group. There was no difference in postoperative mortality between the 2 groups.ConclusionsSingle-stage surgical management by trans-thoraco-phrenotomy can be recommended to treat dual-seat hepatic and pulmonary hydatid disease with fewer complications and a rapid return to work. This technique is easier and safer for right lung and liver dome hydatid cysts.