[Conservative surgical treatment of pulmonary hydatid disease in children]

Abstract

Background: Hydatide disease is endemic in sheep and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Bosnia and Herzegovina.

Objective: Retrospective appraisal of the presentation, approach to surgical treatment and outcome of hydatid disease in children at the Clinic for Thoracic Surgery UCC Sarajevo between January 2000 and January 2007.

Patients and methods: We surgically treated 58 patients (48 male, 10 female) with a diagnosis of pulmonary hydatid disease with average age of 11,36 +/- 3,78 (range 4 to 15) years. Chest radiographs, computed tomograms and ultrasonography were the main methods of diagnosis. The basic principle of surgery was to preserve lung parenchyme as much as possible.

Results: Clinical assessment of the symptoms, plain and lateral chest X-rays and computed tomograms led to the correct diagnosis in 100,0% (58/58) of patients. Solitary lung cyst was found in 68,97% (40/58) patients while the remaining 31,03% (18/58) were multiple cysts in one or more lobes of one or both lungs. Intact cysts were found in 51,35% (38/74) and ruptured cysts in 48,65% (36/74) cases. Lung preserving surgical interventions were done in all of the patients. Postoperative complications were seen in 5,17% (3/58) patients. There was no mortality. Recurrent hydatid cysts were observed in 3,45% (2/58) patients.

Conclusion: Lung preserving surgical interventions are the treatment of choice for pulmonary hydatid cysts in children. Radical surgical procedures such as segmentectomy, lobectomy and pneumonectomy should be avoided as much as possible.