Surgical experience of 825 patients with thoracic hydatidosis in Iraq

Abstract

Abstract

Infection with Echinococcus granulosus is the most common helminthic zoonosis, with a major medical, social and economic burden in Iraq.

Introduction

this study was designed to evaluate retrospectively 825 patients with thoracic hydatid cyst, treated surgically in our department between June 2001 and February 2007.

Methods and Material

The predominant gender of the studied patients were male (61.1%) with age range from 30 months to 79 years (average 31 years). The main clinical presentations were recurrent chest infection, haemoptysis, chest pain and accidental radiological findings. a) The correct preoperative diagnosis could be made by plain chest roentgenogram, chest ultrasound and computed tomography.

Results

The surgical access was through postero lateral thoracotomy in 466 patients, limited thoracotomy in 313 patients, bilateral staged thoracotomies in 17 patients, combined thoracotomy with transdiaphragmatic hepatic access in 21 patients, with transdiaphragmatic splenic access in 3 patients, median sternotomy in 3 patients and video-assisted thoracic surgery in 2 patients. Approximately 63% of intrapulmonary cystic lesions were found in the right lung. Associated liver or other abdominal organs cysts were found in 120 (14.54%) patients. Conservative surgical procedures were adopted except for small wedge resections in 51 patients, segmentectomy in 36 patients and lobectomy in 6 patients.

Conclusions

Limited thoracotomy and conservative surgical procedures should be preferred for cosmetic skin appearance, good postoperative recovery and less postoperative pain. Surgery is still the main stay treatment for pulmonary hydatid disease. Radical procedures such as pneumonectomy, lobectomy and segmentectomy should be avoided as far as possible.