Pulmonary Hydatid Cyst Etiology, Diagnostic Modalities and Surgical Management

Abstract

Background: Pulmonary hydatid cyst is a common parasitic disease in endemic regions and remains a significant health problem in Iraq. Surgical treatment remains the cornerstone of management. Objective: To evaluate the clinical presentation, diagnostic work-up, surgical management, and outcomes of patients with pulmonary hydatid cysts and to compare the study findings with those reported in national, regional and international studies. Methods: A retrospective study was conducted on 56 patients with pulmonary hydatid cysts who underwent surgical treatment in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City  Complex, Baghdad, Iraq, between January 1, 2019, and December 31, 2023. Demographic data, clinical presentation, radiological findings, operative procedures, postoperative complications, morbidity, and mortality reviewed. Results: The patients' ages ranged from 6 to 64 years, with a mean age of 28.9 years. Thirty patients (53.6%) were males, and 26 (46.4%) were females. Four patients (7.1%) were asymptomatic and diagnosed incidentally. Cough was the most common presenting symptom, occurring in 36 patients (64.3%). Posterolateral thoracotomy was performed in 37 patients (66.1%), whereas video-assisted thoracoscopic surgery (VATS) was used in 19 patients (33.9%). Aspiration–evacuation was the most frequently performed surgical procedure (32.1%). Postoperative complications occurred in 12 patients (21.4%), with wound infection being the most common complication. No mortality was recorded. Conclusion: Pulmonary hydatid cyst remains a prevalent disease in Iraq. Early surgical intervention, whether by thoracotomy or VATS, provides excellent outcomes and minimizes the need for major pulmonary resection associated with complicated cysts.