| Hydatid disease is still a major health concern in the
World Health Organization’s Eastern Mediterranean
Region countries [1]. The disease has the ability to affect
all organs, but the liver is the organ most commonly
affected followed by the lungs. Numerous modalities have
been introduced for diagnosing pulmonary hydatid disease
[2]. Surgery, however, remains the treatment of choice,
with various approaches used to save as much of the lungs
as possible. Recurrences appear because of intraoperative
spillage of the hydatid daughter cysts into the pleural
cavity, with most studies indicating recurrence rates for
pulmonary hydatid disease of 4.6–22.0 % [3–5].
Mahmodlou et al. [1], despite a cyst perforation rate of
29.4 %, reported no recurrences. They compared their
results with the study of Mottaghian and Saidi [5] in which
a recurrence rate of 1.5–12.0 % had been reported. The
follow-up period of the studies conducted by Mottaghian
and Saidi [3–5] was 6 months to 3 years, a range reported
by most authors to be sufficient for identifying recurrence
of the disease, although some use a minimum of 4 years for
their follow-up protocol. The follow-up period of the study
conducted by Mahmodlou et al. was 6 months, a time span
too short to compare their results with those of similar
studies or to make any definitive statements about a zero
recurrence rate.
Accidental rupture or spillage of cysts during the operation
might lead to consequent regrowth of the cysts. Thus,
the operative field should be kept clear of contamination by
irrigating the pleural cavity with hypertonic saline. Also,
the cysts should be handled with very gentle manipulation.
These precautionary measures along with chemotherapy
and a thorough follow-up program might avoid recurrence
of the disease. |