One-stage operation via median sternotomy and phrenotomy for bilateral lung and liver hydatid disease

Abstract

Background: Echinoccosis is an endemic disease throughout the world. We reviewed a series of 26 bilateral lung and liver hydatid treated surgically via median sternotomy and either phrenotomy or laparotomy.Aims: This study was conducted to emphasize the importance of one-stage operation via median sternotomy for multiple hydatid cysts. Materials and Methods:This study is a retrospective review of our surgical skills for treatment of hydatid cysts. From January 1990 to January 2001, 173 patients were operated for hydatid disease in Heybeliada Thoracic Surgery Center. Twenty-six (15%) of them had bilateral lung hydatid cysts including 17 concomitant liver cysts. Median sternotomy was performed in all of 26 cases and phrenotomy was commonly used to remove concomitant liver cysts at the same operation. Cystotomy without capitonnage was the most common operative procedure for both lung and liver cysts.Results: There was no operative and postoperative death. Post-operative complications occurred in only two patients; these were atelectasis and wound infection. The mean follow-up was 7.3 years (ranging from 1 to 12 years). No recurrence was recorded both in lung and in liver.Conclusions: One-stage operation using median sternotomy and phrenotomy should be preferred to stage thoracotomies in suitable cases with multiple hydatid cysts. Cystotomy without capitonnage and closure of the bronchial openings can be an alternative procedure in hydatid disease surgery. Albendozole treatment is necessary in the postoperative period to obtain good results without any recurrence, and J Thorac Cardiovasc Surg, 2005; 21: 167-170)

Bilateral staged thoracotomy for multiple lung hydatidosis

“…Single-session surgery via median sternotomy is a rational intervention for bilateral lung hydatidosis. It provides high postoperative patient comfort and shorter duration of hospital stay [12,13]. However, the sine qua non rule in surgical treatment is to ensure the complete eradication of cysts.…”