Cystic hydatid lung disease in northwest Canada.

OBJECTIVE

To determine the optimal treatment of sylvatic cystic hydatid lung disease.

DESIGN

Retrospective case study.

SETTING

Five Edmonton hospitals serving northern Alberta and parts of the Northwest Territories.

PATIENTS: Fourteen patients with cystic (Echinococcus granulosus) hydatid lung disease.

INTERVENTIONS: Cyst enucleation, wedge resection and pulmonary lobectomy.

MAIN OUTCOME MEASURES: Eradication of pulmonary hydatid disease and complications of treatment.

RESULTS

Mean patient age was 32 years. Eight patients were symptomatic. Liver cysts were present in three patients. One of the three patients managed by observation required surgery for an expanding cyst. Surgery (13 procedures in 12 patients) was successful in eradicating pulmonary hydatid disease: 8 cyst enucleations, 3 wedge resections and 2 lobectomies were done. There was only one major postoperative complication (pneumatocele requiring repeat surgery). Intraoperative cyst rupture occurred in five cases, but anaphylaxis or seeding did not result. There were no bronchopleural fistulae.

CONCLUSIONS

Sylvatic cystic hydatid lung disease is more benign than pastoral hydatid disease. Patients with asymptomatic cysts should be managed by observation. Surgery, consisting of endocyst enucleation or wedge resection, is indicated for symptomatic, enlarging or infected cysts.