Surgical approach to lung hydatid cysts in children.

PURPOSE: The aim of this study was to determine the treatment options for pulmonary hydatid cysts (HC) in children according to the size and location of the cyst and the presentation of the patients. METHODS: Children with HC treated between 2004 and 2022 were evaluated. Patients were grouped according to the size of the HC and those with ruptured and intact cysts at the time of admission, and the data were compared. ROC curve was created to determine the HC size limit in operated patients. P < 0.05 was considered statistically significant. RESULTS: A total of 72 patients with a mean age of 8.9 ± 3.4 years were included in the study. HC sizes 2.5–18 cm, and half of the patients had bronchial/pleural ruptures at presentation. Forty-six patients (64%) underwent surgery. Bronchial ruptured HCs were smaller in size (p = 0.021). In cases where the cyst contents were evacuated by opening the bronchus, improvement in clinical and radiological findings was observed with anthelmintic treatment (n = 17, 81%). The cutoff point on the ROC curve was determined as 6.1 cm. CONCLUSION: Surgical treatment should be planned without delay for HC exceeding 6 cm in size. In patients with bronchial rupture and coughing up the cyst contents, only medical treatment can be applied.