Surgical management of complicated pulmonary hydatidosis]

1954-1988, 680 patients with pulmonary hydatid cysts were operated upon at our hospital. 320 of the patients were classified as having complicated pulmonary hydatidosis (CPH). The criteria for CPH are as follows: (1) huge in size, occupied 2/3 or one side of the chest; (2) ruptured hydatid cyst or cysts, with or without secondary infection; (3) multiple lesions involving both lungs, sometimes combined with liver involvement; (4) the presence of hepato-pleural and/or hepato-bronchial fistulae. We advocated intact endocystectomy and saucerization of the residual actocystic pit for individual lesion. The diagnosis and management of different CPH, especially those with hepato-pleural or hepato-bronchial fistulae were discussed in detail. There were 2 operative deaths. The mortality rate of the whole series was 0.29%, and of those with CPH was 0.6%.