Surgical treatment of pulmonary hydatidosis: a single-centre experience of four years

Abstract

Background

Hydatid disease is endemic in sheep-raising regions of the world. It is caused by the larval stage of a tapeworm Echinococcus granulosus. The lifecycle of Echinococcus revolves between sheep and dog. Humans get the infection by ingesting the eggs. Lungs are the second most common site of involvement after the liver. We review our 4-year experience of surgical treatment of pulmonary hydatid cysts.

Methods

Clinical presentation, radiological investigations, operative techniques, postoperative outcome and follow-up of 120 cases of pulmonary hydatid cysts treated surgically were studied between June 2009 and June 2013 at SSKM Hospital, Kolkata.

Results

There were 68 males (56.67 %) and 52 females (43.33 %). The median age of presentation was 33 years. A total of 111 patients were from rural areas with farming and cattle raising as their occupation. Lung hydatid cysts are usually asymptomatic before reaching large sizes. Cough and chest pain are often the only symptoms. The right lung was affected in 58.33 % of cases and the left lung was affected in 35 % of cases. The right lower lobe was most commonly involved (26.67 %). Enucleation of the cyst with capitonnage was the preferred technique. The mean duration of hospital stay was 9.3 days. Oral albendazole was used in postoperative period at the dose of 10 mg/kg/day for 3 months. The recurrence rate was 0.33 %.

Conclusions

Surgery in the form of enucleation and capitonnage is the most effective treatment for pulmonary hydatid cyst as it causes removal of the cyst without spillage and maximum preservation of the lung parenchyma. Povidone-iodine is a good scolicidal agent to prevent contamination of the surgical field from spillage of the cyst contents. Albendazole should be used postoperatively.