Management of bilateral pulmonary hydatid cysts

Objectives Hydatidosis is a parasitic disease common in Mediterranean countries; the most often affected organs are the liver and the lungs (PHC pulmonary hydatid cyst). It’s usually asymptomatic and discovered incidentally. However there are a number of patients who present with bilateral forms (BPHC) and will require a complex management with significant morbidity and mortality rates. The purpose of this work was to report the specific management of these complicated forms. It should be considered that there are many situations with no consensus, such as: conventional regular surgery or not, approaching the bilateral cysts in one session or two, place of pleurectomy for intrapleural ruptured cysts, and timeline in the management for the associated KHP and liver location. The important criteria are a more simple immediate postoperative course and less long term recurrence. Methods We reviewed the records of 2041 patients operated on for pulmonary hydatid cyst in our department during a 30-year period (1983-2012).Results The BPHC essentially affected young population. 9,16% had BPHC scattered throughout both lungs, including 63 patients (3,07%) had pulmonary extra localization (mainly liver). 81,28% of patients (n=152) benefited two-stage surgery. In our series the morbidity was 19% and the mortality was 2,67%.Conclusion The BPHC is a surgical pathology whose prognosis depends fundamentally on the stage of evolution, the cysts location, the number of cysts, and the quality of the initial treatment