Surgical management of pulmonary hydatidosis in children.

UNLABELLED Cystic echinococcosis (CE), the most common manifestation of the infestation with the larval form of the tapeworm Echinococcus granulosus, is a public health problem in endemic areas such as Moldavia. AIM To retrospectively analyze pediatric patients who underwent surgery for pulmonary hydatid cyst over a 5-year period in order to assess the need for extensive lung resection. MATERIAL AND METHODS In the interval January 2007 - January 2012 30 pediatric patients with pulmonary hydatid cyst were surgically treated in the Department of Pediatric Surgery at the Iasi "St. Maria" Children's Hospital. We retrospectively reviewed the medical records of these patients. RESULTS Patient age ranged from 3 to 14 years, and 21 patients (70%) came from rural areas. Respiratory symptoms (cough, chest pain, hemoptysis, fatigue, and dyspnea) were the main complaints. Chest radiography, computed tomography and serological tests made the diagnosis in all cases. The most common location of cystic lesions was the left lower lobe (40%). All patients were treated by enucleation and capitonnage of the residual cavity. Postoperative complications occurred in 5 cases (16.67%) and in one case (3.33%) a new hydatid cyst was diagnosed in the right lung after 2 years. CONCLUSIONS The surgical treatment of choice was cyst enucleation with capitonnage, thus sparing the pulmonary parenchyma. Major lung resections are to be avoided in children when no severe lung destruction is detected.