RECEP TUNCER, SEMA ORHAN, NURİ ŞEN, REFİK ARSLAN, İBRAHİM AYDOĞDU, HASAN OKUR, ERBUĞ KESKİN, ÜNAL ZORLUDEMİR, IŞIK OLCAY
Annals of Medical Sciences - 2000;9(2):59-62
Purpose: In children, the lung is the most common site for hydatid cysts. As there is no effective medical therapy, surgery is the choice of treatment. The aim of this retrospective study is to analyze the results of surgery in children with pulmonary hydatid cysts. Methods: Records of 58 patients with pulmonary hydatid cyst were reviewed. Forty patients had pure lung hydatidosis while 18 had concomitant liver hydatid disease. Thoracotomy was used in all but six. Of these six, five children with concomitant liver dome cysts were treated by thoracophrenolaparatomy and one was managed with percutaneous drainage. In patients with bilateral diseases, staged thoracotomies were performed. Cystectomy, cystectomy and capitonnage, and percutaneous drainage procedures were the choice of treatment as conservative interventions while lobectomy, and segmentectomy as radical procedures. Results: Sixty-three primary surgical interventions (44 conservative surgical, 19 radical surgical) were performed. Peroperative rupture of cyst occurred in seven patients. Four of them received conservative surgeries and three radical procedures. There were five recurrences in the follow-up period. Two of them had peroperatively ruptured pure lung cysts. Comparison between conservative and radical surgical interventions showed no significant difference on postoperative complications and mean hospitalization duration but recurrence rate was found to be significantly higher in the conservative surgery group. No significant difference was found on recurrence rate between ruptured and nonruptured groups. Also, there was no significant difference between thoracophrenolaparatomy and thoracotomy on postoperative complications, recurrence rate and mean hospitalization duration. Conclusions: The treatment of pulmonary hydatid disease is surgical. Although lung preserving surgical interventions are the treatment of choice in childhood, radical surgical procedures could be used without hesitating. In the presence of right lung and concomitant liver hydatid cyst with dome localization, thoracophrenolaparatomy is a safe surgical approach.
