Review of cases with cystic hydatid lung disease in a tertiary referral hospital located in an endemic region: A 10 years' experience

Background: Echinococcus disease is endemic in sheep- and cattle-raising ar eas world wide. Its prevalence is also high in the Mediterranean region inc luding Turkey. Objective: To determine the presentation, approach to surgic al treatment and outcome of hydatid disease in an endemic region. Methods: From January 1989 to December 1998 288 patients, aged between 1 and 71 year s with a mean age of 31 yea rs (134 female, 154 male), were operated on for pulmonary hydatidosis. Clinical charts of the patients were reviewed retro spectively in a tertiary referral hospital. Results: Of 288 patients, 30 pa tients were asymptomatic, the rest (89%) were symptomatic, cough and chest pain being the most common symptoms. Fifty-three patients (18%) had associa ted liver hydatid cysts. Bilateral lung hydatid cysts were present in 18 pa tients (6%). Recurrent hydatid cysts were observed in 33 patients (11%). Se venty-seven patients (27%) presented with complicated hydatid cysts. Postop erative morbidity was observed in 3 patients [bronchopleural fistula (2), i nfection of the cyst space (1)] and postoperative mortality in 1 patient wh o presented with hydatid lung disease associated with liver and brain cysts . In the remaining 98.6%, no complications were noted. Conclusions: In conc lusion, hydatidosis is still an important public health problem in Turkey a nd in an endemic country such as Turkey hydatid lung disease should be cons idered initially in a patient presenting with a corresponding chest roentge nogram and a compatible epidemiologic history. Surgery is indicated in all symptomatic and/or enlarging or infected cysts. When necessary lobectomy or wedge resection can be the procedure of choice. Single-stage combined rese ction is preferred in hydatid lung disease with associated liver hydatid cy sts. Total postoperative complication and mortality rate is low and we reco mmend a close follow-up of the operated cases to diagnose postoperative rec urrence early in Its course. Copyright (C) 2000 S. Karger AG, Basel.