Efficacy and Safety of Surgical Techniques in the Management of Pulmonary Hydatid Disease: A Retrospective Cohort Study.

Objective The primary objective of this study was to evaluate the effectiveness and safety profile of various surgical interventions used to manage pulmonary hydatid cysts, comparing patient outcomes such as postoperative morbidity, hospital stay duration, postoperative mortality, and complication rates across different surgical techniques. Methods This retrospective observational cohort study was conducted at the Department of Thoracic Surgery at Lady Reading Hospital, Peshawar, Pakistan, from January 1, 2023, to December 31, 2023. Patients with surgical treatment of pulmonary hydatid cysts were included. Surgical techniques ranged from lung-sparing procedures, such as cystotomy with capitonnage, enucleation, and pericystectomy, to more extensive resections, including wedge resection, segmentectomy, lobectomy, and pneumonectomy. Primary outcomes included postoperative morbidity, hospital stay duration, pain scores, and 30-day mortality. Statistical analysis was performed using analysis of variance (ANOVA) and Fisher's exact test, with a significance threshold of p < 0.05. Results A total of 180 patients were included. The mean age of patients was 37.45 ± 11.28 years; 105 (58.33%) were men, and 75 (41.67%) were women. Cystotomy with capitonnage was performed in 97 patients (53.89%), showing the shortest hospital stay (9.4 ± 3.1 days) and the lowest morbidity (18 patients, 18.56%). Pneumonectomy was conducted in four patients (2.22%) and was associated with the longest hospital stay (17.8 ± 7.1 days) and the highest morbidity (three patients, 75.00%). Postoperative mortality occurred in three patients (1.67%), all of whom underwent extensive resections. The overall postoperative complication rate was 23.89% (43 patients), with chest pain in 99 patients (55.00%), cough in 81 (45.00%), and fever in 27 (15.00%). Statistically significant differences in hospital stay (ANOVA: p = 0.001) and morbidity (Fisher's exact test: p = 0.01) were found, favoring lung-sparing techniques. Conclusion Lung-sparing procedures, particularly cystotomy with capitonnage, were associated with superior outcomes, including shorter hospital stays, lower morbidity, and no mortality, in this cohort. These findings support the prioritization of conservative surgical approaches in managing pulmonary hydatid disease (HD), especially in endemic and resource-limited settings.