WJCS  Vol.5 No.3 , March 2015
What Is the Best Surgical Approach for Bilateral Pulmonary Hydatid Cysts in Children?
Author(s) Aram Baram
Introduction: The most common site for hydatid cysts in children is the lungs while in adult hepatic cysts are predominant. Bilateral pulmonary involvement is relatively rare and its surgical management is poorly described in the current literature. Until now no definite consensus has been described in the literature for the ideal surgical approach in pediatric bilateral pulmonary hydatid cysts (BPHC). The aim of this prospective cohort study was to describe the problems encountered in treating pediatric BPHC by two different surgical techniques. Patients and Methods: Between June 2007 and June 2014, 60 children (group one = 31, group two = 29) with BPHC were operated on in our center. Group one included all children with BPHC operated by single session bilateral anterolateral mini-thoracotomy. Group two included all cases operated by two stage standard posterolateral thoracotomy at 21 days interval. Results: In group one (19 males and 12 females), the mean age was 8.9 years (3.5-17). In group two, there were 29 cases (18 males and 11 females), the mean age was 9.6 years (2-17). There was no significant statistical difference in terms of the presentations and age distribution. The duration of surgery in group one was significantly shorter and the duration of hospital stay was significantly shorter as well (group one 3.6 days versus 4.6 days in the second group). Pain scale was not more in the first group as it was believed to be. Conclusion: We believe that single session bilateral anterolateral thoracotomy is a better approach than either one stage successive thoracotomies, median sternotomy or clamshell thoracotomy as it involves less postoperative pain and does not precipitate a decrease in the respiratory capacity.

Cite this paper
Baram, A. (2015) What Is the Best Surgical Approach for Bilateral Pulmonary Hydatid Cysts in Children?. World Journal of Cardiovascular Surgery, 5, 30-38. doi: 10.4236/wjcs.2015.53006.
[1]   Balci, A.E., Eren, N., Eren, S. and Ulku, R. (2002) Ruptured Hydatid Cysts of the Lung in Children: Clinical Review and Results of Surgery. The Annals of Thoracic Surgery, 74, 889-892.

[2]   Kuzucu, A., Soysal, O., Zgel, M.O. and Yologlu, S. (2004) Complicated Hydatid Cysts of the Lung: Clinical and Therapeutic Issues. The Annals of Thoracic Surgery, 77, 1200-1204.

[3]   Topcu, S., Kurul, I.C., Tastepe, I., Bozkurt, D., Gülhan, E. and Cetin, G. (2000) Surgical Treatment of Pulmonary Hydatid Cysts in Children. The Journal of Thoracic and Cardiovascular Surgery, 120, 1097-1101.

[4]   Mirshemirani, A.R., Razavi, S. and Sadeghian, S. (2009) Surgical Treatment of Pulmonary Hydatid Cyst in 72 Children. Tanaffos, 8, 56-61.

[5]   Gajbhiye, A.S., Sonak, M.M., Meshram, M.M., Kathod, A.P. and Gajaralwar, R.S. (2013) Surgical Management of Pulmonary Hydatid Cyst. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 6, 59-64.

[6]   Tantawy, I.M. (2010) Hydatid Cysts in Children. Annals of Pediatric Surgery, 6, 98-104.

[7]   Pejhan, S., Zadeh, M.R.L., Javaherzadeh, M., Behgam, M., Shadmehr, Arab, M., Kakhki, A.D., Farzanegan, R. and Dezfouli, A.A. (2007) Surgical Treatment of Complicated Pulmonary Hydatid Cyst. Tanaffos, 6, 19-22.

[8]   Biswas, B., Ghosh, D., Bhattacharjee, R., Patra, A., Basuthakur, S. and Basu, R. (2004) One Stage Surgical Management of Hydatid Cyst of Lung & Liver by Right Thoracotomy & Phrenotomy. Indian Journal of Thoracic and Cardiovascular Surgery, 20, 88-90.

[9]   Karavdic, K. and Guska, S. (2011) Surgical Treatment of Pulmonary Hydatid Disease in Children—A Retrospective Study. Medical Archives, 65.

[10]   Petrov, D.B., et al. (2001) Surgical Treatment of Bilateral Hydatid Disease of the Lung. European Journal Cardio-Thoracic Surgery, 19, 918-923.

[11]   Cetin, G., Dogan, R., Yuksel, M., Alp, M., Ucanok, K., Kaya, S. and Unlu, M. (1988) Surgical Treatment of Bilateral Hydatid Disease of the Lung via Median Sternotomy: Experience in 60 Consecutive Patients. The Journal of Thoracic and Cardiovascular Surgery, 36, 114-117.

[12]   Jakob, H., Kohlhaüfl, M., Hürter, T., Steppling, H. and Oelert, H. (1989) Echinococcal Disease of Both Lungs and Liver: Successful Simultaneous Resection. The Journal of Thoracic and Cardiovascular Surgery, 97, 640-641.

[13]   Karaoglanoglu, N., Kurkcuoglu, I.C., Gorguner, M., Eroglu, A. and Turkyilmaz, A. (2001) Giant Hydatid Lung Cysts. European Journal Cardio-Thoracic Surgery, 19, 914-917.

[14]   Caushi, F., Qirjako, G., Bani, I., Hatibi, A., Skenduli, I., Shima, E. and Menzelxhiu, A. (2013) How to Manage the Complicated Hydatid Cyst of the Lung? Is Any Special Surgical Procedure More Preferred? Journal of Cardiothoracic Surgery, 8, P147.

[15]   Vlad, D.C., Neghina, A.M., Dumitrascu, V., Marincu, I., Neghina, R. and Calma, C.L. (2013) Cystic Echinococcosis in Children and Adults: A Seven-Year Comparative Study in Western Romania. Foodborne Pathogens and Disease, 10, 189-195.

[16]   Aslanabadi, S., Zarrintan, S., Abdoli-Oskouei, S., Salehpour, F., Zarrintan, A., Beheshtirouy, S., Abdollahi, H. and Badebarin, D. (2013) Hydatid Cyst in Children: A 10-Year Experience from Iran. African Journal of Paediatric Surgery, 10, 140-144.

[17]   Khanday, Z.S., Deepak, J., Bagdi, R.K., Balagopal, Agarwal, P., Madhu and Balamourougane (2009) Video-Assisted Thoracic Surgery in Children: Our Institutional Experience. Sri Ramachandra Journal of Medicine, 1, 45-48.

[18]   Talaiezadeh, A.H. and Maraghi, S. (2006) Hydatid Disease in Children: A Different Pattern Than Adults. Pakistan Journal of Medical Sciences, 22, 329-332.

[19]   Singh, H., Kohli, H., Grewal, A. and Budhiraja, S. (2008) Anaesthetic Considerations in a Child with Bilateral Hydatid Cysts of Lung. Indian Journal of Anaesthesia, 52, 849-852.

[20]   Khalilzadeh, S., Baghaie, N., Ghafarzadeh, B., Shadmehr, M.B. and Velayati, A.A. (2004) Hydatid Pulmonary Disease in Children: A Nine-Year Study. Tanaffos, 3, 43-48.

[21]   Montazeri, V., Sokouti, M. and Rashidi, M.R. (2007) Comparison of Pulmonary Hydatid Disease between Children and Adults. Tanaffos, 6, 13-18.