A Surgical Priority for Echinococcal Cysts in the Lung and Liver: One or Two-Stage?

Abstract

AIM: This study aimed to evaluate the surgical outcomes of liver and lung hydatid cysts treated either simultaneously or in separate stages. The main focus was to determine the impact of surgical timing on postoperative complications and overall patient recovery, with an emphasis on minimally invasive techniques.

METHODS: A retrospective analysis was conducted on 42 patients diagnosed with concomitant liver and lung hydatid cysts between March 2009 and July 2020. Surgical procedures included video-assisted thoracoscopic surgery (VATS), thoracotomy, laparoscopy, and laparotomy. Patient demographics, cyst characteristics, concomitant diseases, surgical procedures, postoperative complications, and recovery times were analyzed. The statistical significance of surgical outcomes between one-stage and two-stage procedures was assessed using appropriate statistical tests.

RESULTS: Demographic analysis revealed that 57.1% of the participants were female and 42.9% male, with an average age of 36 years. Comorbidities were present in 23.8% of patients, with chronic obstructive pulmonary disease (COPD) being the most common at 11.9% and asthma at 7.1%. The complication rate was 35.3% in patients who underwent lung hydatid cyst surgery and 30.8% in those who underwent liver and lung hydatid cyst surgery. Although there was no statistically significant difference among the three groups (p = 0.840), liver surgery was associated with a longer hospital stay (p = 0.013). Minimally invasive surgical techniques (VATS, laparoscopy) had a lower complication rate (20% versus 40.9%, p = 0.143). These results suggest that minimally invasive techniques can reduce the risk of complications.

CONCLUSIONS: The timing of the surgical procedure, whether performed in one or two stages, had no significant effect on the complication rate. Minimally invasive techniques are recommended due to their lower complication rate and shorter recovery time.