Right Upper Lobectomy for a Hydatid Cyst Using U-Vats

The patient is a thirty-two-year-old man who is a nonsmoker with no prior medical history living in a rural area. He consulted his pneumologist after experiencing dyspnea and hemoptysis. In the chest CT scan, a large hydatic cyst was seen to be taking up most of the right upper lobe. The patient underwent a right upper lobectomy when, after removing the cyst, the residual cavity had a large proximal fistula on an upper lobe that was not ventilating correctly. The surgery went smoothly with no postoperative complications. The patient was discharged on postoperative day four with a follow up chest X-ray.

Surgical management of hydatid cysts has always avoided major surgical resection and parenchyma should be preserved as much as possible. However, in some cases this may not be an option, especially if the cyst is quite large. In literature, the rate of a lobectomy in pulmonary hydatid surgery is reported to range from 0.5 percent to 45 percent, ranging from 13 percent for large cysts (3).

Reference(s)

1. Nabi MS, Waseem T. Pulmonary hydatid disease: What is the optimal surgical strategy? Int J Surg. 1 janv 2010;8(8):612‑6.

2. Usluer O, Ceylan KC, Kaya S, Sevinc S, Gursoy S. Surgical Management of Pulmonary Hydatid Cysts: Is Size an Important Prognostic Indicator? Tex Heart Inst J. 2010;37(4):429.

3. Giant hydatid lung cysts | European Journal of Cardio-Thoracic Surgery | Oxford Academic [Internet]. [cité 28 nov 2023].