CYSTIC HYDATID LUNG-DISEASE IN NORTHWEST CANADA

Objective: To determine the optimal treatment of sylvatic cystic hydat id lung disease. Design: Retrospective case study. Setting. Five Edmon ton hospitals serving northern Alberta and parts of the Northwest Terr itories. Patients: Fourteen patients with cystic (Echinococcus granulo sus) hydatid lung disease. Interventions: Cyst enucleation, wedge rese ction and pulmonary lobectomy. Main Outcome Measures: Eradication of p ulmonary hydatid disease and complications of treatment. Results: Mean patient age was 32 years. Eight patients were symptomatic. Liver cyst s were present in three patients. One of the three patients managed by observation required surgery for an expanding cyst. Surgery (13 proce dures in 12 patients) was successful in eradicating pulmonary hydatid disease: 8 cyst enucleations, 3 wedge resections and 2 lobectomies wer e done. There was only one major postoperative complication (pneumatoc ele requiring repeat surgery). Intraoperative cyst rupture occurred in five cases, but anaphylaxis or seeding did not result. There were no bronchopleural fistulae. Conclusions: Sylvatic cystic hydatid lung dis ease is more benign than pastoral hydatid disease. Patients with asymp tomatic cysts should be managed by observation. Surgery, consisting of endocyst enucleation or wedge resection, is indicated for symptomatic , enlarging or infected cysts.