Place of minimally invasive surgery in the treatment of pulmonary echinococcosis in children

<bold>Introduction:</bold> Pulmonary hydatid cysts in children are common in endemic countries, particularly in Tunisia. Minimally invasive surgery has proved to be an excellent therapeutic method with many advantages for treating this type of pathology. <bold>Methods and patients:</bold> This is a retrospective descriptive study of children under 15 years old operated on for hydatid cysts of the lung via a minimally invasive approach between 2005 and 2022. <bold>Results:</bold> Sixty-one children, 36 boys and 25 girls, were operated on for hydatid cysts of the lung using video-assisted mini thoracotomy (VATS). The mean age was 12 years. These children consulted for hemoptysis (n=18), cough (n=31), chest pain (n=11), dyspnea in a febrile context (n=9). Abdominal ultrasound revealed a hepatic hydatidosis in 10 cases. The cysts were located in the right lung in 32 cases, in the left lung in 27 cases and bilaterally in 2 cases. Surgery consisted in cystectomy and cushioning in 49 cases, wedge resection in 3 cases, segmentectomy in 2 cases, lobectomy in 6 cases and bilobectomy in 1 case. The post-operative course was uneventful in 56 cases. Immediate postoperative complications were pulmonary atelectasis in 4 cases. One child with congenital heart disease died postoperatively. No recurrence was reported. <bold>Conclusion:</bold> Surgery is the treatment of choice for pulmonary hydatid cyst. Video-assisted mini thoracotomy (VATS) is the preferred approach, provided that the same procedures as for open surgery are followed to avoid recurrence. It is associated with better postoperative results and less pain.