Comparison of cystectomy and lobectomy of lung hydatid cyst in pediatrics: a retrospective study

Abstract

Objective: Hydatid cyst is an endemic disease in Iran. The treatment of choice for pediatric lung hydatid cysts is surgical removal of the cyst. However, due to its high prevalence the risk of recurrence after the surgery, cystectomy with capitonnage, which preserves the lung tissue, is a favorable surgical approach compared to lobectomy. Herein, we compared the outcome of cystectomy and lobectomy of lung hydatid cysts. Methods & Materials: This is a retrospective study conducted in the pediatric surgery department. Pediatric patients who had undergone surgery due to pulmonary hydatid cysts were enrolled. The patients were divided into two groups including cystectomy and non-anatomic lobectomy. Then, the length of surgery, length of hospitalization, postoperative complications, and the time required to remove the chest tube were calculated in each group. Results: A total of 32 patients were enrolled in this retrospective study. Age, sex, location, and size of cysts were not significantly different between the two groups. The duration of surgery in the lobectomy and cystectomy groups was 116.3±33.7 versus 116.1±28.2 minutes, respectively (P=0.53). Surgery complications including the need for blood transfusion, pneumothorax, need for bronchoscopy and atelectasis were not different between the study groups. The mean time for first chest tube removal was significantly different between the groups with the lobectomy group having a shorter time (P=0.02). The length of hospital and ICU stay were not different between the two surgical procedures. The time to remove the first chest tube was significantly higher in cystectomy compared to lobectomy (P=0.02). Conclusion: The complications and outcome of the cystectomy are comparable to the lobectomy technique. However, the cystectomy method has the advantage of preserving the lung tissue, therefore it’s a favorable technique in endemic areas for hydatid cysts where reoperation may be indicated.