Abstract:
Introduction: The most common site for hydatid cysts in children is the lungs while in adult hepatic
cysts are predominant. Bilateral pulmonary involvement is relatively rare and its surgical
management is poorly described in the current literature. Until now no definite consensus has
been described in the literature for the ideal surgical approach in pediatric bilateral pulmonary
hydatid cysts (BPHC). The aim of this prospective cohort study was to describe the problems encountered
in treating pediatric BPHC by two different surgical techniques. Patients and Methods:
Between June 2007 and June 2014, 60 children (group one = 31, group two = 29) with BPHC were
operated on in our center. Group one included all children with BPHC operated by single session
bilateral anterolateral mini-thoracotomy. Group two included all cases operated by two stage
standard posterolateral thoracotomy at 21 days interval. Results: In group one (19 males and 12
females), the mean age was 8.9 years (3.5 - 17). In group two, there were 29 cases (18 males and
11 females), the mean age was 9.6 years (2 - 17). There was no significant statistical difference in
terms of the presentations and age distribution. The duration of surgery in group one was significantly
shorter and the duration of hospital stay was significantly shorter as well (group one 3.6
days versus 4.6 days in the second group). Pain scale was not more in the first group as it was believed
to be. Conclusion: We believe that single session bilateral anterolateral thoracotomy is a
better approach than either one stage successive thoracotomies, median sternotomy or clamshell
thoracotomy as it involves less postoperative pain and does not precipitate a decrease in the respiratory
capacity
