Surgical Management of Lung Hydatidosis. A Monocentric Experience: At Habib Bourghiba University Hospital, Sfax-Tunisia

Abstract

Kleriene Souza, Zied Chaari and Imed Frikha

Introduction: Hydatidosis is a parasitic disease caused by the larval form of the Taenia Echinococcus granulosus in human which is considered as the accidental intermediate host. Hydatidosis is widely seen in the Mediterranean region, South America, Australia and New Zealand. The liver is the most common location followed by the lung in adults. Material and methods: We report a monocentric experience of the surgical management of lung hydatidosis in a total period of 6 years from January 2012 to December 2017 in the Department of Thoracic and Cardiovascular surgery in the University hospital Habib Bourguiba in Sfax, Tunisia.
Results: A total of 80 patients had surgery for lung hydatidosis with a mean age of 42,5 years +/-15 years (7-78) and a SEX RATIO = 1,16. In 67 cases (83, 75%) pulmonary hydatid cysts was unique and unilateral, and the cyst was bilateral in 3 cases (5%). The cyst was multiple in 3 cases (3, 25%). The mean location was the right lung (46.7%). Cystectomy was performed in all patients. Surgery was completed by closure of bronchial fistula in 52 cases (65%). Anatomical resection (lobectomy) was necessary only in 2 cases (2, 5%). The evolution was simple in 70 cases (87, 5%) and complicated in 10 cases with a total morbidity rate of 12, 5%. The main complications were: fever, pneumonia, hemothorax, empyema and atelectasis. The peri operative mortalility was about 2, 5%.
 Conclusion: Conservative surgical procedure (cystectomy) is the treatment of choice of lung hydatidosis specially the uncomplicated ones. This simple procedure is safe, reliable and successful. However anatomical resections should only be carried out in selected patients with specific indications.

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