Secondary thoracic echinococcosis is a rare condition due to the availability of both early diagnosis and effective treatment. This study analyses tactical and technical aspect of the complex treatment of this severe complication of hydatid disease.
During the last 20 years we have treated a total number of 12 patients with thoracic secondary echinococcosis. Primary location of hydatid cyst was pulmonary in 9 cases and hepatic in 3 cases (transdiaphragmatic migration). Most patients required complex procedures –multiple cystectomies associated with resection and decortication (8), decortication (2) and cure of hepatic lesion (3). In order to prevent hydatid recurrence we used pleural lavage with alcohol (3 patients) or formaldehide (1 patient), associated with postoperative treatment with mebendasole.
We had one postoperative death through sepsis in a patient admitted to our unit in cardio-respiratory arrest. There was a significant morbidity, with 4 patients requiring re-operation: one drainage of a subphrenic abscess, one decortication and suture of a bronchial fistula, one thoracopleuroplasty and one wound debridation. We had one late lumbar recidive, solved through a lumbar approach.
Secondary thoracic echinococcosis is a severe complication of hydatid disease due to the extent of lesions and associated infection, which requires complex surgical procedures and involves a high morbidity.
Due to the complexity of the disease there is no clear standard for surgical approach of secondary thoracic echinococcosis and each patient must be very carefully analysed. This paper is also an argue for early diagnosis and treatment of hydatid disease.
A.M. Botianu, None.