Lung Hydatid Cysts in Children, Evaluation and Surgical Management

Author(s): Burkan Nasr, Anwar Al_junaeed, Ghaleb Al Sady, Ahmad Al Shehari, Ali Amri, Mohammed Issa, Abdulhakim Al Tamimi, Saeed Al Bahlooli, Mohammed Al_Sormi, Abdulfattah Altam, Yasser A Obadiel, Mohammed Al-Shehari, Ali Hiddan.

The aim of this study was to review the problems encountered in treating pediatric patients with complicated ruptured lung hydatid cysts and to highlight the risks associated with delays in surgical treatment for lung hydatid disease.

Methods: A prospective analysis of 50 pediatric patients with lung hydatid cysts, surgical management was performed in Saudi Hospital at Hajjah,Yemen. Between April 2015 and April 2022, the patients were divided into two groups, intact noncomplicated (group 1, n = 27) or complicated (group 2, n = 23). A complicated cyst was that had ruptured into a bronchus or into the pleural cavity. Data related to symptoms, preoperative complications, surgical procedures performed, postoperative morbidity, and hospitalization time were collected from patient’s parents, medical record and the group findings were compared.

Result: Fifty surgical procedures were performed: 45 posterolateral thoracotomies, 2 posterolateral thoracotomies with phrenotomy, two posterolateral thoracotomies with laparotomy and one case tube thoracostomy. Cough, chest pain and dyspnea was main presented symptoms in both groups. In addition to these, the patients with complicated cysts presented with expectoration of cystic contents, hemoptysis, productive sputum, and fever. The differences between the groups with respect to the rates of preoperative complications and postoperative morbidity, frequency of decortications, and hospital stay were statistically significant (p < 0.05).

Conclusions: Surgery is the primary mode of treatment for pediatric patients with lung hydatid disease. Complicated cases have higher rates of preoperative and postoperative complications and require longer hospitalization times and more extensive surgical procedures than uncomplicated cases.