Pneumonectomy in the surgery of pulmonary Hydatid cysts: A therapeutic option that is sometimes unavoidable

Abstract

Introduction: A parenchyma-saving operation is the rule in the treatment of pulmonary hidatid cyst (PHC). However, pneumonectomy can be necessary in some situations. Material : Retrospective study over a period of 20 years including 5 patients who underwent pneumonectomy for pulmonary hydatidosis. Results: The average age was 45 years old with a female predominance of 80%. Three patients had a history of complicated PHC treated by cystectomy (1 case) and liver hydatid cyst operated on (2 cases). Two patients presented a pulmonary hydatid embolism treated medically (1 case) and surgically (1 case). The main symptoms were chest pain (5 cases), dry cough (5 cases). Chest computed tomography, performed in all patients, revealed voluminous fluid tone masses, homogeneous well limited, occupying one lobe (1 cases), two lobes (2 cases) and three lobes (2 cases) with pulmonary hydatid embolism in two cases. Four patients had pneumonectomy for a destroyed hepatized lung and one patient a totalisation pneumonectomy, through a posterolateral thoracotomy in all cases. The mean duration of postoperative drainage was 3 days. The histological study confirmed the diagnosis. The postoperative course was simple for 3 patients. Two postoperative complications were reported: Cardiac arrythmia and postoperative pneumonia. Conclusion : In pulmonary hydatidosis surgery, lung tissue should be preserved and resection should be avoided whenever it is possible. However, Pulmonary resection becomes unavoidable if irreversible changes have occurred throughout the lung and a large amount of parenchyma is attached to the cyst. This highlights the importance of rigourous prophylaxis and early diagnosis.