The cornerstone of hydatidosis of the chest wall : Recurrence

<bold>Introduction:</bold> Hydatidosis of the thoracic wall is a rare condition affecting the bone (ribs and vertebrae) and soft tissue. Its treatment is difficult, mainly surgical, and postoperative recurrence is frequent. The aim of this study is to investigate the recurrence of echinococcosis of the chest wall. <bold>Methods:</bold> We conducted a retrospective, descriptive and multicentric study in four University-hospitals of Tunis conducted between January 1995 and December 2023. We included all operated hydatid cyst of the chest wall. <bold>Results:</bold> we collected 49 cases of hydatidosis of the chest wall. Recurrence occurred in 18 cases (37%). The median time to recurrence was 1± 0.47 years (one month to 13 years). Treatment of recurrence was essentially surgical combined with medical treatment in 83% of cases, aiming for complete resection if possible, decompression of the spinal cord and stability of the spine. The main surgical procedure was as conservative as possible, with flattening of hydatid abscesses and copious lavage in 8 cases, decompression by laminectomy more or less associated with partial corporectomy in 8 cases, rib resection in one case and complete corporectomy in one case. The mean number of repeat surgeries for recurrence was three. The immediate outcome of the treatment of recurrence was marked by complete recovery in four patients, partial recovery in ten patients and no improvement or worsening of neurological status in four cases. <bold>Conclusion:</bold> Recurrence remains the cornerstone of this rare pathology , and the factors associated with it need to be studied in order to improve its prognosis.