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Single-centre experience in treatment of multiple-site hydatid disease in a tertiary care centre of Eastern India

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

Single-stage surgery for multiple-site hydatid cysts especially for the lung and liver is a less performed approach.

Objective

The aim of the study is to assess the feasibility of this approach in terms of outcome.

Methods

We studied 42 patients with multiple-site hydatid cysts over a period of 36 months admitted or referred to the department of CTVS of a tertiary-level hospital of Eastern India.

Results

Maximum numbers of cases were found in the age group of 11–20 years comprising 35.71% of the patient population with a female preponderance (18 versus 24). Chest pain was the commonest presenting feature (66.66%) followed by cough (52.38%), haemoptysis and dyspnoea 33.33% respectively. Eosinophilia was observed in four patients (9.52%). Twenty-two patients had simultaneous occurrence of pulmonary and hepatic hydatid disease (52.38%). Fourteen patients had only pulmonary involvement (33.33%). Chest wall (including the parietal pleura) was involved in six patients (14.28%). 23.03% patients presented with complicated cysts in the form of rupture into the pleura (19.35%) or the peritoneum (9.68%). Eighteen patients (42.86%) were operated via posterolateral thoracotomy and 18 (42.86%) were operated via thoracotomy with phrenotomy. Twenty-four patients (57.14%) underwent cyst excision by Barrett’s technique. 59.09% patients underwent cystostomy for hepatic hydatids and five underwent omental packing (22.72%). Prolonged air leak was the commonest complication (35.71%). The mean operative time for thoracotomy was 136.87 min (~ 140 min) and 145 min for thoracotomy with phrenotomy. Only five patients (11.9%) required a prolonged intensive –treatment unit (ITU) stay of > 2 days and four had prolonged hospital stay > 15 days (1 of bronchopleural fistula, 1 of anaphylactic shock and 1 of bilateral lung cyst excision with postoperative lobar collapse).

Conclusion

Single-stage surgery is a viable option for multiple- and multi-site hydatids.

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Authors and Affiliations

  1. Department of CTVS, RG Kar Medical College, Kolkata, India

    Shilpa Gandhi, Bhaskar Das, Rajarshi Basu & Subrata Dey

  2. DNB Thoracic Surgery, Plot No. 208, 2nd Floor, Abhyankar Nagar, Nagpur, Maharashtra, 440010, India

    Shilpa Gandhi

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  1. Shilpa Gandhi
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  2. Bhaskar Das
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Correspondence to Shilpa Gandhi.

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The authors declare that they have no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. A copy of approval from the ethical committee can be made available for review by the Editor-in-Chief of this journal.

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Gandhi, S., Das, B., Basu, R. et al. Single-centre experience in treatment of multiple-site hydatid disease in a tertiary care centre of Eastern India. Indian J Thorac Cardiovasc Surg 35, 461–467 (2019). https://doi.org/10.1007/s12055-018-0743-y

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