**9. Prevention**

**Figure 28.** specimen of parietectomy for rib hydatid cyst with hydatid cyst material cotenant (arrow)

In adult, some authors [21] have reported the successful use of thoracoscopic procedures for the treatment of pulmonary hydatid disease. Sporadic cases were founded in the French and the other in the English literature. In our experience, we have treated three patients through this procedure. Postoperative course was uneventful in all cases. The thoracoscopic approach in pulmonary hydatid cysts must follows the same principles of the open technique, which include sterilization of the cyst with scolicidal agents (eg. hy‐ pertonic saline), complete excision of the endocyst, and closure of bronchial fistula, if present. The main advantage offered by thoracoscopy is less trauma and discomfort for the patient. The lack of intercostal muscle incision and the lower risk of rib fracture re‐ duce the postoperative pain and when compared to thoracotomy, thoracoscopy reduces the chest tube duration and length of hospital stay. Conversion to thoracotomy is mainly

Although surgery remains the treatment of choice for hydatid disease, the usefulness of drug therapy has been reported in many studies. Medical treatment is an alternative to sur‐ gery where a surgical approach is not recommended in risk patients, and in cases with small and multiple lesions in one or more organs, or proximity of cysts to major vascular struc‐ tures. Antihelminthic agents, Mebendazole, and more recently albendazole, and praziquan‐ tal, reduce recurrence post-operatively, particularly where there has been spillage of cyst

Many and substantial questions still remain unanswered, however. What is the optimum duration of treatment? Clearly, duration of treatment of < 3 months produces less than optimal response, whereas results of extension beyond 6 months have yet to be gauged

*8.1.3. Video assisted thoracoscopic surgery*

214 Principles and Practice of Cardiothoracic Surgery

related to major pleural adherences.

**8.2. Medical therapy**

contents [22].

Necessary to strictly observe good personal hygiene when the content of the dogs and care for them, and be sure to wash your hands after contact with the dog, not to allow dogs to the food of man and his pot, limit direct exposure of children and dogs. Stray dogs are ev‐ erywhere to be catching. In addition to current (and past) hydatid control campaigns, there have been significant technological improvements in the diagnosis and treatment of human and animal cystic echinococcosis, the diagnosis of canine echinococcosis, and the genetic characterization of strains and vaccination against *E. granulosus* in animals. Incorporation of these new measures could increase the efficiency of hydatid control programmes, potential‐ ly reducing the time required to achieve effective prevention of disease transmission to as little as 5 - 10 years.

### **10. Conclusion**

We are of the view that surgical treatment of the lung cyst should be preferred firstly in cases of lung hydatid cyst disease. The diversity of the pathological process offers vari‐ ous tactics and approaches in the surgical treatment which must be individually tailored in each and every case. The goal of surgical therapy is to remove the cyst while preserv‐ ing as much lung tissue as possible and medical treatment may be useful only in no op‐ erable patients.
