The medical and surgery outcomes of pulmonary hydatid cyst disease: A 12-year multidisciplinary experience

BACKGROUND: Pulmonary hydatid cyst disease (PHCD) remains a significant public health problem in endemic regions. AIMS: To evaluate the demographic, serological, radiological, and surgical characteristics of patients with PHCD and to identify factors associated with hepatic involvement and postoperative outcomes. METHODS: This retrospective study included 515 consecutive patients who underwent surgical treatment for PHCD at Dicle University Faculty of Medicine between 2013 and 2025. Demographic characteristics, cyst features, indirect fluorescent antibody (IFA) test results, concomitant hepatic involvement, surgical procedures, postoperative outcomes, and complications were analyzed. RESULTS: Among 515 patients, 275 (53.4%) were male and 240 (46.6%) were female. Female patients were significantly older than male patients (28.0 ± 18.0 vs. 23.8 ± 18.4 years, p = 0.002). Hepatic involvement was significantly associated with positive IFA test results (p < 0.001), bilateral pulmonary disease (p < 0.001), multiple pulmonary cysts (p < 0.001), female sex (p = 0.045), and left-sided pulmonary involvement (p = 0.019). Blood group distribution was not associated with hepatic involvement (p = 0.773), although IFA positivity differed significantly among ABO blood groups (p = 0.006). Larger cyst size was associated with longer hospital stay (r = 0.130, p = 0.003) and prolonged drainage duration (r = 0.094, p = 0.034). Perforated cysts were associated with increased hospital stay (r = 0.180, p < 0.001) and drainage duration (r = 0.139, p = 0.002). Pediatric patients had significantly larger cysts than adults (p = 0.007). CONCLUSIONS: Positive IFA results, multiple pulmonary cysts, and bilateral lung involvement are associated with concomitant hepatic hydatid disease. Cyst size and perforation status significantly influence postoperative recovery, particularly hospital stay and drainage duration. Surgical treatment provides excellent outcomes with low reoperation rates and no disease-related mortality in experienced centers.