Video-Assisted Thoracoscopic Surgery to Treat Hydatid Disease of the Thorax in Adults: Is It Feasible?

Abstract

Optimal treatment of intrathoracic hydatid diseases in adults involves complete removal of the cyst with parenchyma-preserving surgery. In current practice, thoracotomy remains the standard surgical approach for pulmonary hydatid cysts, so surgical experience is limited, particularly with regard to video-assisted thoracoscopic surgery (VATS). Between June 2007 and May 2011, a selected series of 12 adult patients presenting with intrathoracic hydatid cysts underwent VATS. The cysts were completely removed using a three-trocar technique. Complete removal of the cysts was successful in all patients. All cysts were diagnosed by computerized tomography, and 6 (50%) patients had a history of hydatid disease in the liver or lung. No serious postoperative complications were observed. Patients with thoracoscopic excision were discharged after a median of 2.9 days (range, 2-6 days). No recurrences or complications were observed during a mean follow-up of 29 months. Considering the conversion and complication rates in our series, VATS should be the primary therapeutic choice for adults with thoracic hydatid cysts. Open surgical interventions in patients with large and uncomplicated cysts appear optional.