Single-centre experience in treatment of multiple-site hydatid disease in a tertiary care centre of Eastern India

Single-stage surgery for multiple-site hydatid cysts especially for the lung and liver is a less performed approach.

The aim of the study is to assess the feasibility of this approach in terms of outcome.

We studied 42 patients with multiple-site hydatid cysts over a period of 36 months admitted or referred to the department of CTVS of a tertiary-level hospital of Eastern India.

Maximum numbers of cases were found in the age group of 11–20 years comprising 35.71% of the patient population with a female preponderance (18 versus 24). Chest pain was the commonest presenting feature (66.66%) followed by cough (52.38%), haemoptysis and dyspnoea 33.33% respectively. Eosinophilia was observed in four patients (9.52%). Twenty-two patients had simultaneous occurrence of pulmonary and hepatic hydatid disease (52.38%). Fourteen patients had only pulmonary involvement (33.33%). Chest wall (including the parietal pleura) was involved in six patients (14.28%). 23.03% patients presented with complicated cysts in the form of rupture into the pleura (19.35%) or the peritoneum (9.68%). Eighteen patients (42.86%) were operated via posterolateral thoracotomy and 18 (42.86%) were operated via thoracotomy with phrenotomy. Twenty-four patients (57.14%) underwent cyst excision by Barrett’s technique. 59.09% patients underwent cystostomy for hepatic hydatids and five underwent omental packing (22.72%). Prolonged air leak was the commonest complication (35.71%). The mean operative time for thoracotomy was 136.87 min (~ 140 min) and 145 min for thoracotomy with phrenotomy. Only five patients (11.9%) required a prolonged intensive –treatment unit (ITU) stay of > 2 days and four had prolonged hospital stay > 15 days (1 of bronchopleural fistula, 1 of anaphylactic shock and 1 of bilateral lung cyst excision with postoperative lobar collapse).

Single-stage surgery is a viable option for multiple- and multi-site hydatids.