J Minim Access Surg. 2026 Jun 2. doi: 10.4103/jmas.jmas_498_25. Online ahead of print.
ABSTRACT
INTRODUCTION: While minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) are applied, the relative impact of surgical approach versus procedure type on outcomes remains controversial in pulmonary hydatid cyst treatment.
PATIENTS AND METHODS: This retrospective study analysed 192 operations performed in 157 patients with pulmonary hydatid cysts between 2010 and 2023. Patients were stratified by surgical approach (VATS, video-assisted mini-thoracotomy and thoracotomy) and by procedure type (cystotomy, cystotomy + capitonnage, cystotomy + wedge and wedge). Demographic data, cyst characteristics, rupture status, concomitant hepatic hydatidosis, post-operative complications, length of stay and recurrence were evaluated. Statistical comparisons were made as appropriate.
RESULTS: The mean patient age was 38.9 ± 20.2 years; 94 were female (59.5%) and 63 were male (40.5%). Cysts treated with VATS were significantly smaller, likely reflecting selection bias towards thoracoscopic suitability, whereas larger cysts were more often managed with cystotomy + capitonnage. Surgical approach did not significantly affect post-operative complication rates or hospital stay ( P > 0.05). In contrast, procedure type strongly influenced outcomes: cystotomy was associated with prolonged air leak and longer hospitalisation, capitonnage reduced complications but slightly extended recovery, and wedge resections achieved the shortest stays with low morbidity. Overall morbidity, recurrence and hospitalisation duration were comparable between paediatric and adult groups.
CONCLUSIONS: In pulmonary hydatid cyst surgery, prognosis depends primarily on the procedure performed rather than the surgical approach. Parenchyma-preserving techniques – particularly capitonnage and appropriately selected wedge resections – reduce morbidity and accelerate recovery. Surgical planning should therefore prioritise the choice of procedure over the approach to optimise outcomes in pulmonary hydatid disease.
PMID:42262782 | DOI:10.4103/jmas.jmas_498_25
