Lung hydatid and broncho-cavitary communications: Challenges in the management and outcome

Abstract

Background: The aim was to analyse the challenges and outcomes in operated patients of hydatid lung with broncho-cavitary communications. Materials and Methods: The retrospective data between June 2017 and May 2022 were obtained. The number of broncho-cavitary communications was recorded and they were suture repaired using polypropylene. The duration required for repair and the average fall in the SpO2 were recorded. Those with incomplete data or follow-up were excluded. The outcome parameters considered were number of broncho-cavitary communications, duration of stay, duration of intercostal tube, duration of air leak and requirement of ventilator support. Results: A total of 33 patients out of 36 formed the study group. The mean age was 6 years (range 2–18 years). There were 23 right-sided, eight left-sided and two bilateral cysts. Broncho-cavitary communications were seen in 33 patients. The average number of communications was 3 (range: 2–8). The average duration required to suture close the communications was 30 s (range 20–180 s). The average fall in the SpO2 was 40% (range 20%–74%). The main challenge was rapid identification of communications and prompt repair. The mean duration of surgery was 2.15 h (range 1.45–3.15 h). Ventilator support in the post-operative period was required in four patients. The average duration of intercostal tube drainage required was 7 days (range: 6–14 days). The average duration of hospital stay was 14 days (range 12–34 days). All the communications were repaired using Prolene 3-0 sutures. None of the patients was operated with a double-lumen endobronchial tube. Conclusion: Broncho-cavitary communication in hydatid cyst is associated with an operative challenge due to sudden air leak. These patients require judicious management.

Keywords

• air leak
• broncho-cavitary communications
• bronchopleural fistula
• double-lumen endobronchial tube
• hydatid cyst