Effect of 30% hypertonic saline irrigation on serum electrolytes in pulmonary hydatid cyst surgery: A prospective cohort study

Pulmonary hydatid cysts, caused by Echinococcus granulosus, are treated surgically, often with intraoperative protoscolicides like hypertonic saline to prevent recurrence. The safety of 30% hypertonic saline, particularly its effect on serum electrolytes, remains underexplored in pulmonary surgery. This study evaluates the impact of 30% hypertonic saline wash on serum electrolyte levels and associated complications in pulmonary hydatid cyst surgery. A prospective cohort study was conducted at Al-Mouasat Hospital, Damascus, Syria, from June 2023 to December 2024. Twenty-two adults with pulmonary hydatid cysts undergoing surgical resection were included. Fourteen patients received 30% hypertonic saline wash, while 10 did not. Serum sodium levels were measured before, during, and 2 to 4 hours post-surgery. Data were analyzed using repeated measures analysis of variance. The cohort included 14 males (63.6%) and 8 females (36.4%). Cyst locations were 7 right lung, 7 left lung, 2 bilateral, 4 hepatopulmonary, 1 hepatic, and 1 mediastinal. No significant changes in sodium levels were observed (F(2,42) = 0.83, P = .44), with means of 140.00 (standard deviation [SD] 3.77) mmol/L presurgery, 140.82 (SD 3.29) during, and 140.73 (SD 3.43) post-surgery. No hypernatremia or related complications occurred. The use of 30% hypertonic saline wash in pulmonary hydatid cyst surgery does not significantly affect serum sodium levels and appears safe. Further studies are needed to confirm efficacy.