Brief original scientific report: a new surgical approach for the treatment of left pulmonary and hepatic hydatid disease.
BACKGROUND
The combination of pulmonary and hepatic hydatid cysts is frequently encountered, and poses a challenge in terms of surgical accessibility. The surgical treatment of the two locations by the same incision (thoracotomy with phrenotomy) has been proposed, but always from the right side. However, applying this technique to the left side seems to be more difficult and unusual. We herein describe a new left-sided technique that was used to treat two patients with pulmonary and hepatic hydatid cysts.


METHODS
The first patient was 14-year-old; he had bilateral pulmonary hydatid cysts and one type I cyst of the left lobe of the liver. The second patient was a 10-year-old female who had a hydatid cyst of the upper left lobe with one type III cyst of hepatic segments 2 and 3.


RESULTS
Both patients were operated on via a left lateral thoracotomy through the sixth intercostal space. They underwent cystectomy for the left pulmonary hydatid cysts, followed by padding, and then the hepatic cyst was treated by Lagrot's method via a radial phrenotomy. The postoperative course was uneventful in both cases, with postoperative hospital stays of 3 and 5 days, respectively.


CONCLUSIONS
This combined treatment of pulmonary and hepatic hydatid cysts by the left-sided thoracic approach is feasible and provides a good outcome. It should be indicated under the same conditions of accessibility and feasibility applied for the right thoracic side.
Cardio-Thoracic Surgery Department, Abderrahmen Mami University Hospital, Abderrahmen Mami street, 2080, Ariana, Tunisia, mohamedsadok.boudaya@gmail.com.
Mohamed-Sadok
MS
Boudaya
Jalel
J
Mohamed
Anissa
A
Berraies
Hazem
H
Zribi
Adel
A
Marghli
Tarek
T
Kilani
D000293:Adolescent; D002648:Child; D003952:Diagnostic Imaging; D004444:Echinococcosis, Hepatic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004445:Echinococcosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome