Management Of Pulmonary Hydatid Cysts Research Articles

Lung Hydatid Cyst Surgery Conservative Treatment or Anatomical Resection: about 153 patients

Hydatidosis is a parasitic condition caused by contamination of humans by the larval form of Taenia echinococcus granulosus . The lung is the preferred location after the liver. The disease is characterized by the development of one or more cysts within the parenchyma. All cysts should be operated on, whether they are symptomatic or not. The goal of treatment is to eradicate the parasite while preserving as much functional parenchyma as possible. Surgery includes conservative techniques and anatomical resections (Lobectomy; segmentectomy and pneumonectomy). We report the surgical results of retrospective work; analytical and monocentric study on lung damage caused by hydatid disease in 153 cases collected in our department, between January 2019 and June 2022. The average age was 43 years, and all patients underwent open surgery. open ; the parameters studied are demographic data, the concept of contagion, clinical manifestations, paraclinical results; surgical management (technique) and complications. The objective of our work is to analyze the role of surgical treatment in the management of pulmonary hydatid cyst, the different conservative and radical surgical techniques, and to evaluate the incidence of postoperative complications as well as the recurrence rate in depending on each technique used. The results of our study confirmed the correct surgical strategy for each indication which allowed us to obtain zero mortality and very low morbidity.

Capitonnage method for surgical management of pulmonary hydatid cysts: A retrospective study

Introduction: Hydatid disease of the lung, which is caused by Echinococcus granulosus, is commonly found in Mediterranean countries. Surgery is the primary mode of treatment for patients with pulmonary hydatid disease. This study aims to assess the efficacy of capitonnage in the management of the condition. Methods: This retrospective, multicenter study was conducted between February 2017 and December 2019. Patients with different presentations of pulmonary hydatid disease were treated surgically with cyst enucleation and capitonnage technique. The procedure was performed under general anesthesia, in a lateral position. Results: A total of 118 patients with pulmonary hydatid cysts were included in this study. There were 73 (61.9%) male and 45 (38.1%) female, with a mean age of 30 years. More than one-third (45 patients) were asymptomatic, and 73 (61.9%) complained of chest pain, cough, and/or respiratory distress. Forty-nine patients (41.5%) had right lung involvement. No death occurred in this study. Conclusion: when the capitonnage technique is carefully applied to the folds of the pericystic tissue, the rate of atelectasis and distortion is very low and may reduce the risk of postoperative air leaks.

Pulmonary Hydatid Cyst in Children: A Single-Institution Experience.

Objective: Hydatid cysts can occur in any place such as the liver, lung, spleen, kidney, brain, and soft tissue. Pulmonary hydatid cysts are more prone to rupture than liver hydatid cysts. In this study, we aimed to present the demographic characteristics, clinical symptoms, radiological findings, surgical findings, type of surgery performed, and postoperative complications of patients with pulmonary hydatid cysts.Materials and method: The files of 94 patients who were operated on for pulmonary hydatid cysts in our clinic between January 2011 and October 2021 were retrospectively analyzed. The patients were divided into two groups: ruptured pulmonary hydatid cysts and non-ruptured pulmonary hydatid cysts.Results: A total of 120 pulmonary hydatid cysts were detected in 94 patients who were operated on for pulmonary hydatid cysts. Cyst rupture was detected in 63 (52.5%) patients. Rupture was found significantly higher in cysts with a diameter of <10 cm (p=0.005). Complaints of fever and hemoptysis were found significantly higher in the ruptured group. Pneumothorax was detected in six patients after the operation with an average of two months, one of which was the patient who underwent video-assisted thoracoscopy (VATS).Conclusion: Pulmonary hydatid cyst should be kept in mind in children presenting with lower respiratory tract symptoms in regions where echinococcosis is endemic. Parenchyma-sparing methods should be the first choice in the management of pulmonary hydatid cysts. Patients who develop early postoperative complications should also be followed closely for late impediments.

Video-assisted thoracoscopic surgery and mini-thoracotomy compared to conventional thoracotomy in the surgical management of pulmonary hydatid cyst

Background: Although hydatid cyst disease is not common in western countries, it is a public health issue in the Middle East, including Iraq. We describe a new method in the surgical management of the disease. Aim of the study was to evaluate the outcomes of different surgical approaches: video-assisted thoracoscopic surgery (VATS), mini-thoracotomy, and conventional thoracotomy in managing pulmonary hydatid cysts.Methods: Retrospective analysis of the surgical treatment of pulmonary hydatid cysts between January 2017 and December 2021 in two centers. Patients' data regarding the age, sex, sign and symptoms, cyst size and location, surgical approach, operative time, the intraoperative bleeding, chest drainage, hospitalization time, and postoperative complications.Results: A total of 122 patients were included in the study; 9 underwent VATS, 59 underwent mini-thoracotomy, and 54 had conventional thoracotomy. The VATS and mini-thoracotomy has superiority to the thoracotomy group in terms of lower duration of operation, less perioperative bleeding, early chest tube removal, and lower hospitalization time.Conclusions: VATS and mini-thoracotomy are safe and advantageous procedures compared to conventional thoracotomy.

Management of Pulmonary Hydatid Cyst With Pleural Complications: A Case Series

Introduction: The aim of this observational, retrospective study was to review and describe clinical presentations and management of patients with pulmonary hydatid cysts (PHC) and pleural complications. Methods: Complete case records from the previous 2 years were reviewed, including operative steps and follow-up of patients with PHC and pleural complications. Only four cases that presented with pleural complications were found out of 14 cases of surgically managed PHC. Results: The most common symptoms in all patients were chest pain and fever. In all cases, the lower lobes of the lung were involved. Lung resection surgery was not required in any case. There was no postoperative respiratory failure or immediate or late mortality in any of these patients. The mean follow-up was 10 months for all these cases, with no pulmonary recurrence or complications. Conclusion: Pulmonary parenchymal sparing surgical interventions are deemed to be the safest curative treatment for complicated PHC. Spontaneous pyopneumothorax can also be caused by complicated PHC.

Surgical management of pulmonary hydatid cysts in children in KwaZulu-Natal Province, South Africa.

Background Pulmonary hydatid cyst disease is still a major problem in countries like South Africa (SA), where livestock farming is common. Hydatidosis has a variable clinical course depending on the size, location and complications of the cyst. For pulmonary cysts of any size, surgery remains the gold standard for treatment, with lung conservation surgery being the ideal. Objectives To describe the epidemiology, clinical presentation, surgical management, and surgical outcomes of paediatric pulmonary hydatid disease in children referred to the Department of Cardiothoracic Surgery at Inkosi Albert Luthuli Central Hospital (IALCH) in KwaZulu-Natal Province, SA. Methods We retrospectively reviewed and analysed the medical records of 38 children between the ages of 0 and 18 years with pulmonary hydatid cysts, who were referred to the Department of Cardiothoracic Surgery at IALCH and underwent surgical management between 1 January 2008 and 31 December 2018. The medical records were evaluated for patients’ demographics, clinical evaluation, surgical management strategies and surgical outcomes. Results Of the 38 patients, 60.5% were male, with a mean age of 6.5 years. More than two-thirds of the patients (68.4%) were from the Eastern Cape and 31.6% were from KwaZulu-Natal. The majority of the cysts (84.2%; n=32) were classified as large (5 - 9 cm in diameter) and giant (≥10 cm in diameter). Forty-eight surgical procedures were performed and lung preservation surgery by enucleation and capitonnage was preferred. Some patients developed postoperative complications such as prolonged air leaks from bronchopleural fistula (18.8%; n=9) and 88.9% (n=8) of these patients healed with chest tube drainage and physiotherapy. Lung resection was only required in 4% (n=2) of the patients. The mean (standard deviation) number of days spent in hospital was 7 (4) days. All children survived with no recurrences. Conclusion Conservative surgical procedures such as enucleation of the cysts of any size are possible, safe, reliable and reproducible.

Minimally invasive approach for pulmonary hydatid cyst

Hydatid diseases still remain an important health problem in some countries. The primary choice of treatment has been long accepted as surgical treatment including cystectomy/cystotomy with or without capitonnage performed for every cyst. The most important principal for pulmonary hydatid surgery is to preserve as much parenchyma as possible. Anatomical resection is needed in very small fraction of patients. With parallel of improvements in minimally invasive surgery in thoracic surgery, video-assisted thoracoscopic surgical treatment has been reported to be utilized in the management of pulmonary hydatid cyst. The main advantages of minimally invasive techniques is their milder perioperative trauma and less pain as avoiding spreading the intercostal areas. That resulted in lower postsurgical pain, shorter hospital stay, fewer complications and faster recovery after the surgery, better quality of life. Minimally invasive management to the management of lung hydatid cyst including uniportal approach has been proven to be safe and effective and seems to serve better outcomes. The optimal procedures performed should be determined on an individualized basis and requires a careful preoperative evaluation.

Management for hydatid cysts of the lung ruptured in the pleural cavity

Our purpose is to report our experience in the management of pulmonary hydatid cysts ruptured in the pleura. Materiel and methods: We collected all records of patients with a ruptured hydatid cyst of the lung in the pleura who underwent surgery for this in the department of thoracic surgery of the CHU Hassan II of Fes during the 6-year period that started in 2010. The study included 20men and 14women with an average age of 30.44 ± 18.4years. Radiological findings showed a hydropneumothorax in 21cases, hydrothorax in 10, pachypleuritis in 29, and a floating membrane in 13cases. In all cases, pleuropulmonary decortication was associated with pericystectomy in 20cases and parenchymal resection in 3cases. A hydatid membrane bathing in the pleural cavity was found in 32cases. The postoperative course was uneventful in 28cases. Long-term follow-up should be established to detect possible recurrences or pleural dissemination, which appear to be prevented by long-term use of anthelmintic agents.

Pediatric Department Experience in the Treatment of Pulmonary Hydatid Cysts in Children

Pulmonary hydatid cysts in children are a significant public health problem in Tunisia. While hepatic cysts are the most common in adult pathology, the lung is the number one location for hydatid cysts in children which causes a serious problem due to lack of standardized therapeutic strategy. We reported our experience in diagnosis and management of pulmonary hydatid cysts in a pediatric department in southern Tunisia.

Video-assisted Thoracoscopic Surgery (VATS) with mini-thoracotomy for the management of pulmonary hydatid cysts

BackgroundHydatid cyst is an endemic infectious disease. Various modalities have been provided to approach hydatosis. This article reports a 20-years-experience of a new minimally invasive technique for the management of solitary pulmonary hydatid cysts using video-assisted thoracoscopic surgery (VATS) with mini-thoracotomy.MethodsWe reviewed the medical records of patients who underwent unilateral or bilateral single pulmonary hydatid cyst excision using VATS with mini-thoracotomy. All patients were managed by the same surgeon over the period from January 1996 till January 2015.ResultsThe study involved 120 patients aged between 11 and 74 years (median age = 30 years). The overall number of conducted surgeries was 130 (10 patients needed two surgeries). No deaths were reported during or after surgery. No recurrences were seen in the follow-up period that ranged between 10 and 30 months. Three patients (2.3% out of the 130 surgeries) developed post-operative complications: one patient had prolonged air leak and two patients developed empyema.ConclusionVATS with mini-thoracotomy is an effective and safe option for managing intact or ruptured solitary pulmonary hydatid cysts. Further studies in controlled prospective design are needed to compare this approach to other modalities of management.

Thoracoscopic Cystostomy of Pulmonary Hydatid Cyst in Children

Aim: Echinococcosis is still an important health problem throughout the world, particularly in the Mediterranean area. In humans, the lungs are the second most commonly affected sites. The disease may affect children and its treatment may be challenging. In children, small hydatid cysts of the lungs respond favorably to the medical treatment. Surgery is the standard option for the treatment of large and complicated cysts. In current practice, thoracotomy and parenchyme-saving procedures such as cystostomy and capitonnage remain the standard surgical approach for pulmonary hydatid cysts in children. However, surgical experience with thoracoscopy is limited. The aim is to present the experience in thoracoscopic management of pulmonary hydatid cysts in children. Patients and Methods: Medical records of children who underwent thoracoscopic cystostomy of pulmonary hydatid cysts between 2008- 2016 were reviewed. Surgical treatment was recommended for patients who remained symptomatic on medical treatment and when the cyst size was larger than 6 cm in diameter. Parenchyme-saving surgery was preferred which included cystostomy, removal of germinative membrane and control of air leaks. Capitonnage was not preferred because of the risk of deterioration in lung capacity. Results: Fifteen patients underwent 16 thoracoscopy procedures for pulmonary hydatid cysts. One of the patients had bilateral complicated pulmonary hydatid cysts. There were conversions to mini-thoracotomy in 3 (20%) procedures because the air leaks could not be controlled safely. The procedure was completed thoracoscopically in 12 patients. In thoracoscopically completed cases, prolonged air leak (over a week) occurred in 3 (25%) patients and one of them underwent thoracotomy to control bronchopulmonary fistula. One of the patients underwent laparoscopic cystostomy and capitonnage for associated liver hydatid cyst. There were no recurrences during 60 months of mean follow-up time and no problem was observed during the follow-up period. Conclusion: Thoracoscopic management is recommended in children with uncomplicated hydatid cyst. In complicated hydatid cysts, however, thoracoscopic wedge resection is recommended. If there is difficulty in controlling bronchial openings, mini-thoracotomy could be considered.

Management of pulmonary hydatid cysts in a tertiary care centre in Northeast India

Background Hydatid cysts are the most common parasitic disease of the lungs. We reviewed our experience with pulmonary hydatid cysts focusing on clinical symptoms, diagnostic methodology, operative management and their outcome in our centre.

Surgical Management of Pulmonary Hydatid Cyst

Aim of conservative surgical technique to achieve complete removal of cyst and early mobilization in the management of pulmonary hydatid cyst. Material and method:-The prospective study was conducted at Indira Gandhi Government medical college, Nagpur. During the study period seventy two patients operated upon for hydatid disease were evaluated pre and postoperatively. Results: 47 male and 25 female patients were treated with enucleation 33(45.83 %), cystostomy 26 (36.11 %), segmentectomy 05(6.94 %), pericystectomy 04 (5.56 %) and lobectomy in 04(5.56%) patients. In 51(70.83%) patients capitonnage was performed. Mortality in one patient (1.39%) with 11.11% morbidity was observed in the present study. Conclusion: From the present study we conclude that conservative surgical procedure achieved complete removal of cyst and early mobilization in the management of pulmonary hydatid cyst. Bronchial communication should be closed by purse string sutures. These simple procedures are safe, reliable and successful. However radical procedures should only be carried out in selected patients with specific indications.

Parenchyma-Preserving Surgery in the Management of Pulmonary Hydatid Cysts

Pulmonary hydatid cysts remain a significant health problem in endemic regions like Turkey. Here, we present our surgical experience in patients with pulmonary hydatid cysts. Between January 1985 and January 2001, 1118 operations were performed in 1032 patients (528 males, 504 females; mean age 32.7 years; range 1–87 years) with pulmonary hydatid cysts in our department. Posterolateral thoracotomy was performed in 1015 (98.3%), two-stage thoracotomy in 34 (3.3%), and median sternotomy in 17 (1.7%) patients. We preferred conservative surgical procedures. As a surgical procedure, cystotomy and capitonnage was performed in 626 (56%), cystotomy alone in 368 (33%), wedge resection in 81 (7%), enucleation in 29 (3%), and decortication in 11 (1%) patients. None of our patients were treated with anatomic resection. During surgery, 949 patients (92%) had unruptured and 83 patients (8%) had ruptured hydatid cyst. The morbidity ratio was 6.7%. Major complications were wound infection (2.3%), prolonged air leak (1.9%), atelectasis (1.2%), pleural effusion (0.8%), postoperative hemothorax (0.6%), and empyema (0.3%). Two patients (0.2%) died within the first month postoperatively. Mean follow-up was 31.2 months. Recurrence was detected in only 35 patients (3.3%). Treatment of pulmonary hydatid cyst is primarily surgical. Medical treatment is indicated for recurrent and multiple hydatid cysts postoperatively. Cystotomy alone, or cystotomy and capitonnage, as parenchyma-preserving surgery, is preferred. Radical surgery including pneumonectomy, lobectomy, and segmentectomy should be avoided.

Minimal access therapy in pediatric pulmonary hydatid cysts

Hydatid cysts occur commonly in lungs in the pediatric age group. Though medical management has been tried, definitive management of the condition is essentially surgical. Use of video-assisted thoracic surgery (VATS) has been rarely employed for the management of pulmonary hydatid cysts. We present a 10-year-old boy with pulmonary hydatid cysts treated with VATS-assisted minithoracotomy with hydatid cyst enucleation and capitonnage. The patient developed a lung abscess postoperatively and had to undergo lobectomy. The surgical management of pulmonary hydatid cysts is discussed here. The role of minimal access therapy for pulmonary hydatid cysts is highlighted.

Surgical management of pulmonary hydatid cysts in children.

Hydatid disease is common in Libya with a prevalence of 2%. Surgery of pulmonary hydatid disease remains the best treatment and aims to remove the cyst or its remnants and obliterate the residual cavity. Forty three consecutive patients under 15 years of age were investigated by plain chest radiography, ultrasonography of the abdomen, and indirect haemagglutination tests. At thoracotomy the parasite or its remnants were removed and the bronchial fistula sutured. All but four of the patients were discharged within 12 days. These four had had their large cavities obliterated by purse string sutures and developed air fluid levels with cavity reformation at the cyst site. They were treated conservatively by physiotherapy and antibiotics and remained in hospital for 2-3 weeks. There was only one recurrence after three years of follow up. Pulmonary hydatid cysts in children can be treated successfully by evacuation and obliteration. The methods described can also be applied to adults.