One stage bilateral thoracotomy for hydatid cysts of both lungs

Abstract

Background

Though pulmonary hydatids are quite frequent in India, bilateral pulmonary hydatids are rare. Generally two stage posterolateral thoracotomy is done for surgical resection of bilateral hydatids. Our objective was to study the safety of one stage bilateral small thoracotomies for managing bilateral pulmonary hydatids.

Methods

From 1996 through 2003, 216 pulmonary hydatid cysts were managed surgically. Out of 18 cases of bilateral cysts, 12 cases were managed with one stage bilateral thoractomy. One stage anterolateral mini thoracotomies with 30° tilt were done on both sides, one after another. Hydatid cysts were removed, bronchial leaks were sutured and dead spaces were obliterated. In two patients, segmentectomy & in one patients lobectomy was done due to destroyed lung parenchyma. Chest was closed with water seal drains. Post operative albendazole was continued for 3 months in the dose of 10–20 mg/kg with a gap of 2 weeks after each month. Post operative recovery was uneventful in most of the cases.

Results

Out of 216 patients of hydatid lung, 12 (5.55%) were managed surgically with one stage bilateral thoracotomy. Mean age was 24.3 years (youngest 9 years and oldest 72 years). Male: female ratio was 7: 5. Mean operating time was 90 mints. (Range 70 mints. to 130 mints). Average blood loss in chest drain was 300 ml. There was no mortality and no major complications Air leak continued for 3 weeks in 2 patients. Till date there is no recurrence.

Conclusion

One stage bilateral mini thoractomy is a suitable & safe option for surgical management of bilateral pulmonary hydatids.