Hydatid cyst (HC), the most parasitic disease of the lung, is still an important health problem in Tunisia. In this study, we reviewed our experience in a surgical management of 33 patients with giant pulmonary hydatid cyst (GPHC) (diameter ≥ 10 cm). Between 1998 and 2019, a total of 33 patients with GPHC were operated in the Thoracic Surgery Department in Abderrahmane Mami Hospital. Seventeen were males (51.51) and 16 were females (48.48%). The median age was 33.9 years (range 7–83 years). The diameters of the cyst ranged between 10 and 20 cm (mean 13.15 cm). The most common symptoms were chest pain (63.63%) and cough (33.33%). Imaging showed a single GPHC in all cases. GPHC was intact in 75.75% cases and complicated in 24.25% cases. Posterolateral thoracotomy was performed in 27 cases (81.81%). For the residual cavity, parenchyma-saving procedures were performed in 54.54% and anatomical resection was performed in 45.46%. Morbidity was low, and no mortality was seen. GPHC are considered more difficult to treat surgically than small cysts; parenchyma preserving should and could be the surgical method of choice with a good prognosis. The decision of anatomical pulmonary resection is taken in per-operative when conservative surgery is not possible.

中文翻译：

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大型包虫囊肿的处理：三级中心经验

袋虫囊（HC）是肺部最寄生的疾病，在突尼斯仍然是重要的健康问题。在这项研究中，我们回顾了我们在33例巨大肺囊虫囊肿（GPHC）（直径≥10 cm）患者的外科手术治疗中的经验。在1998年至2019年之间，共有33名GPHC患者在Abderrahmane Mami医院的胸外科进行了手术。男性17位（51.51），女性16位（48.48％）。中位年龄为33.9岁（范围7-83岁）。囊肿的直径在10到20厘米（平均13.15厘米）之间。最常见的症状是胸痛（63.63％）和咳嗽（33.33％）。影像显示在所有情况下都只有一个GPHC。GPHC完整的占75.75％，复杂的占24.25％。后外侧开胸手术27例（81.81％）。对于残留腔，节省实质性手术的比例为54.54％，解剖切除术的比例为45.46％。发病率低，未见死亡。GPHC被认为比小囊肿更难手术治疗。保留薄壁组织应该并且可能是具有良好预后的首选手术方法。当不可能进行保守手术时，应在手术时决定解剖肺切除。