Treatment of pulmonary hydatid cyst: Review

Hydatid disease still remains an important health problem in Turkey. Surgery remains the principal mode of treatment of echinococcosis, as chemotherapy with benzimidazole compounds is not yet satisfactory. Medical treatment has been used as an adjunct to surgery to diminish recurrence and potential spread of the organism. General policy in the surgical management of pulmonary hydatid disease is the conservative surgery. Capitonnage for obliteration of the residual cavity is usually advocated. Studies on the application of the percutan aspiration of cyst contents in pulmonary hydatid cysts are insufficient, with limited patient numbers, and have shown more severe complications than methods used for other organ cysts. Video-assisted thoracic surgery is possible to remove the cystic membrane thoracoscopically, but uncontrolled spillage of cyst contents may cause anaphylaxis, pleural hydatidosis, or pleural bacterial spread. Definitive surgery for a bronchobiliary fistula entails excision of the fistula tract and lung tissue destroyed by the necrotizing bronchopneumonia. Endoscopic interventions could be applied successfully to treat bronchobiliary fistula. The tube thoracostomy, percutaneous drainage of subphrenic collections or cysts, and antibiotics have been successfully used in the management of plevrobiliary fistula.