Single-Stage Transthoracic Surgery of Right Pulmonary and Hepatic Hydatid Cysts: A Retrospective Study of Fourteen Patients.

Background: The association of pulmonary and hepatic hydatid cysts is rare. Managing this condition with low mortality and complications is a challenge. The aim of this study is to put forward our experience in managing both sites in single-stage posterolateral thoracotomy. Patients and Methods: A retrospective study of 14 patients who underwent single-stage posterolateral thoracotomy and phrenotomy to treat right lung and liver hydatid cysts between January 2010 and December 2019 were reviewed. Results: Fourteen of 135 patients (10.4%) with double location of hydatid disease were treated in our department for pulmonary hydatid cysts in the same period. There were nine males and five females who were 20 to 72 years old (average age, 42.7 years). Chest computed tomography (CT) and abdominal scan were performed in all cases. The surgical approach was posterolateral thoracotomy and phrenotomy without laparotomy in all cases. Conservation of hepatic and pulmonary parenchymas was possible in 13 patients (92.8%). Average operative time was 122 minutes (range, 95-210 minutes) and the average post-operative hospital stay was 8.7 days. Post-operative complications occurred in two (14.3%) cases, one was atelectasis and the other persistent biliary and air leakage. There was no post-operative mortality. All patients received post-operative medical treatment for three to six months and there was no recurrence after an average follow-up of 26 months. Conclusion: Single-stage thoracotomy is a better option than thoracotomy and laparotomy for the management of double located hydatid cysts. It has a lower complication rate, shorter hospital stay, and rapid resumption of normal activity.

Parenchyma sparing procedures is possible for most pulmonary hydatid disease without recurrence and low complications.

OBJECTIVE: A retrospective review of 223 patients (242 operations) of pulmonary hydatid cysts. We analyze and evaluate our experience in the surgical management of this Moroccan endemic disease and concluded that parenchyma-saving must be always used. MATERIALS AND METHODS: In an 8 year period (2002 -2009), 223 patients (242 interventions, 282 pulmonary hydatid cysts) were operated on in our department. There were 166 males and 57 females with a mean age of 45.7 years. The diagnosis was established on the basis of different clinical signs and imaging studies. Surgical approach consisted of a posterolateral thoracotomy in all cases. Different surgical procedures were performed on the pulmonary lesions according to the localization, the size, the complicated or intact cyst and the importance of lung destruction. RESULTS: Parenchyma-saving were done in 217 patients (238 interventions) cases, including cystectomies (189 cysts), pericystectomies (47cysts) with capitonnage of the cavity in 177 cysts. Radical treatment as lobectomies is used in only 6 cases. Postoperative minors complications occurred in 13 cases (5.4%), including 6 prolonged air leak, 4 pneumonias, one wound infection and two transitory residual cavities. There was no postoperative death. All patients were free of recurrence of thoracic hydatid disease in a follow-up ranging from 3 to 90 months (mean: 49 months). CONCLUSION: Hydatid cysts of the lung should be treated before complications. Parenchyma saving is the best procedures for this benign disease; the radical resection must be reserved only for pulmonary destruction.

Primary axillary hydatid cyst.

Echinococcosis is a zoonotic infection, affecting humans in a characteristic geographic distribution. The disease generally involves the liver, the lung and sometimes an axillary location. We reported a case of 43-year-old man, who was diagnosed with a cystic lesion of the left axilla, which was presumed to be a hydatid cyst or a vascular malformation by ultrasound and computed tomography. Surgical excision of the lesion was performed confirming the hydatid cyst diagnosis by histological studies.