65 KMUJ 2014, Vol. 6 No. 2 ORIGINAL ARTICLE 1  Head of Thoracic Surgery, Gulab Devi Chest Hospital, Lahore, Pakistan Email: gsraza@yahoo.com 2 Postgraduate Resident-Thoracic Surgery, University of Health Sciences, Gulab Devi Chest Hospital, Lahore, Pakistan 3 Consultant Paediatric Surgeon, Gulab Devi Chest Hospital, Lahore Date Submitted: June 23, 2013 Date Revised: March 21, 2014 Date Accepted: March 28, 2014 SURGICAL MANAGEMENT OF HYDATID LUNG DISEASE: EXPERIENCE IN GULAB DEVI HOSPITAL, LAHORE Ghulam Shabbir Pervez 1  , Saima Sultan 2 , Farman Ali Laghari 3 ABSTRACT OBJECTIVE: To evaluate the outcome of surgical intervention for hydatid lung disease in our set up. METHODOLOGY: This cross sectional study was conducted at depart- ment of Thoracic Surgery, Gulab Devi Chest Hospital, Lahore, Pakistan on 72 cases of Hydatid lung disease, operated from 2009 to 2011. Pa- tients of any age of either gender, hospitalized for surgical intervention for Hydatid lung disease were included in the study. Patients declared unfit for surgery or anesthesias were excluded. Standard thoracotomy was the procedure adopted in majority of cases. Sternotomy and Ab- domino-thoracic approach was adopted in a smaller group of patients on requirement of location of cysts. Data were collected and analyzed by SPSS version 20. RESULTS: Male female ratio was 40/32 and most of them belonged to age group 31-50 years. Fifty six (77.8%) patients were symptomatic at presentation. Unilateral cysts were seen in 45 (62.5%) csases, multiple cysts in 15 (20.8%) and bilateral cysts in 12 (16.7%) cases. Ruptured hydatid encountered in 24 (33.3%) cases. Cystectomy and obliteration of space was done in 58 (80.5%), lobectomy in 10 (13.9%) and wedge resection in 4 (5.6%) patients. Postoperative course was uneventful in 60 (83.3%) cases, major complication were observed in 06 (8.3%) patients, minor complications in 06 (8.3%) patients and one (1.4%) patient died. No recurrence was reported during one year of follow up. CONCLUSION: Surgery for hydatid lung disease is safe in majority of cases as it involves very little morbidity/ mortality and provides complete cure of the disease. KEY WORDS: Ecchinococcus, Hydatid cyst, Tapeworm. THIS ARTICLE MAY BE CITED AS: Pervez GS, Sultan S, Laghari FA. Surgical management of hydatid lung disease: Experience in Gulab Devi hospital Lahore. Khyber Med Univ J 2014; 6(2): 65-68. INTRODUCTION H ydatid disease, parasitic infection caused by Echinococcus Granulosus is a zoonotic disease involves human beings accidentally. 1 More than 1 million people are affected with echinococcosis at any one time. It is caused by larvae, which are the metacestode stage of the tapeworm Echinococcus. Out of four forms of Echinococcosis (cystic echinococcosis, alveolar echinococcosis, polycystic echinococcosis, and unicystic echinococcosis), cystic echinococcosis and alveolar echinococcosis are clinically important for human beings. 2 Hydatid disease is endemic in countries where sheep and cattle are raised. 3,4 Dogs and other canines are the definitive hosts while sheep, cattle, horses and pig are intermediate hosts. 5 E. granulosus is the most widespread of the species, with areas of high endemicity in southern South America, the Mediterranean coast; the southern part of the former Soviet Union; the Middle East; southwestern Asia and northern Africa Australia. 5 In Pakistan, a high prevalence of hydatidosis has been reported in the lungs and livers of sheep and goats. 6 Hydatid cyst can be found virtually in any organ (primary Echinococcosis) and 85-90% show single organ involvement. Lung (25%) is the second most com- monly involved organ after liver (63%). 7 Thoracic involvement can occur through transdiaphragmatic route (0.6-16% of cases of hepatic disease) as well as hae- matogenous spread. 8 Pulmonary cysts need surgical removal as their size can compromise the lung to a great extent. Furthermore, their rupture can lead to death of a patient either due to anaphy- lactic shock or due to obstruction in respiratory passage because of coughing out of cyst. Surgery is considered the treatment of choice since the parasite can be completely removed and the patient cured. 9 Surgical options for lung cysts include cystectomy, lobectomy and Decortication. Cystectomy is safest possible procedure. Very few studies are available from Pakistan on pulmonary hydatid cysts. 10,11 Hence this study was planned to evaluate the outcome of surgical intervention for hydatid lung disease in our set up.