Treatment approach in bilateral pulmonary hydatid cysts: analysis of 107 consecutive cases.

OBJECTIVE

Bilateral pulmonary involvement is observed in around 14% of cases of pulmonary hydatid cysts and the treatment can be challenging. This study evaluates the clinical characteristics and treatment strategies used for cases of bilateral pulmonary hydatid cysts.

MATERIALS AND METHODS

A retrospective examination was conducted on 107 consecutive cases of bilateral pulmonary hydatid cysts treated in our clinic between January 2003 and December 2023.

RESULTS

Out of the 107 cases analyzed, 57 (53.3%) were male and 50 (46.7%) were female. Surgical intervention was performed for pulmonary hydatid cysts in 92 cases (86.0%), while medical treatment was prescribed for the remaining 15 cases (14.0%). Bilateral thoracotomies were consecutively conducted in 77 cases; in 11 cases, thoracotomy was carried out on one side and contralateral hydatid cysts were treated medically. Three cases underwent sternotomy, and one underwent bilateral thoracotomy during a single session. One case experienced postoperative hemorrhage, three cases had prolonged air leakage, two cases had empyema, one case had a wound infection, and one case had a recurrence of hydatid cyst. For bilaterally operated cases, albendazole treatment commenced after the second operation and was carried out in two 15-day cycles. Patients who declined, or were not eligible for surgery, were treated with albendazole for an extended period.

CONCLUSIONS

Consecutive bilateral thoracotomy, followed by two cycles of albendazole therapy, is a highly effective treatment for patients with bilateral pulmonary hydatid cysts. In cases with widespread involvement, ruptured small cysts, or serious comorbidities, long-term medical treatment including albendazole administration may be applied.