RESUMO
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a highly prevalent clinical condition and frequently associated with obesity. Recent literature has suggested the independent contribution of OSAS in the pathogenesis of metabolic disturbances. Metabolic syndrome (MS), a cardiovascular risk factor, was frequently associated with OSAS. METHODS: This is a prospective study without intervention. Will be included, all consecutive patients referred to the Department of Pulmonology for suspected OSAS confirmed by respiratory polygraphy. Anthropometric, clinical and biological parameters needed to define the MS will be collected. MS was defined according to the IDF 2005. Assessment of cardiovascular risk related to MS will be performed by appropriate scores. EXPECTED RESULTS: To determine the prevalence of MS in a sample of OSAS patients recruited in the Department of Pulmonology of Farhat Hached Hospital (Sousse, Tunisia). To identify risk factors independently associated with the presence of MS in patients with OSAS among the following parameters (age, gender, degree of obesity and the various parameters of OSAS severity). To assess compared cardiovascular risks according to the presence of MS by validated scales to demonstrate the impact of MS in patients with OSAS.
Assuntos
Síndrome Metabólica/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Humanos , Prevalência , Estudos Prospectivos , Medição de Risco , Tunísia/epidemiologiaRESUMO
INTRODUCTION: Lung hyperinflation (LH) has become a major concern in the management of chronic obstructive pulmonary disease (COPD). MAIN AIM: To evaluate the role of lung volumes in the positive diagnosis of COPD and in the assessment of airway obstruction reversibility. POPULATION AND METHODS: Three hundred and sixty-six male smokers over the age of 35 with more than 40 pack-years exposure were included in the study. Plethysmographic data were determined before/after taking a bronchodilator (BBD, ABD). Applied definitions: airflow obstruction: BBD FEV1/FVC<0.70. LH: BBD residual volume (RV)>upper limit of normal. Expressions of reversibility: Δvariable=(ABD-BBD) values; Δinit%=Δvariable/BBD value and Δref%=Δvariable/reference value. A 12%init and a 0.2L increase in either FEV1 or FVC or a 10%ref or - 300 mL decrease in RV were considered as clinically significant. RESULTS: Over the 85 smokers without airflow obstruction, 68% had LH. In the hyperinflated group (n=314), and compared to changes in FEV1 and FVC, these RV changes detected more respondents (54% for FEV1 and FVC vs. 65% for RV, P=0.002). This was not the case for the group free from LH (n=52) (23% for FEV1 and FVC vs. 35% for RV, P=0.09). In the 58 hyperinflated groups free from airflow obstruction, and compared to changes in FEV1 and FVC, changes in RV detected more respondents (24% for FEV1 and FVC vs. 71% for RV, P=0.0001). CONCLUSION: In heavy smokers, it seems essential to include LH as a criterion for a positive diagnosis of COPD and of reversibility evaluation.
Assuntos
Pulmão/patologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Fumar/patologia , Tabagismo/patologia , Adulto , Idoso , Humanos , Estudos Longitudinais , Pulmão/fisiopatologia , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valor Preditivo dos Testes , Doença Pulmonar Obstrutiva Crônica/patologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Índice de Gravidade de Doença , Fumar/efeitos adversos , Fumar/fisiopatologia , Tabagismo/complicações , Tabagismo/diagnóstico , Tabagismo/fisiopatologiaRESUMO
INTRODUCTION: Studies of the spirometric profiles of narghile smokers are few, have some methodological limits (i.e. small sample size), and present contradictory conclusions. AIMS: (i) To determine the percentage of narghile smokers with obstructive ventilatory defect (OVD) and/or restrictive ventilatory defect (RVD) or static hyperinflation (SHI); (ii) to compare the chronological and estimated lung ages. INCLUSION CRITERIA: men aged 20 to 60 years, narghile smokers (>1 narghile-year [NY]). EXCLUSION CRITERIA: cigar or cigarette smokers and comorbidity. Narghile use quantification: NY and kg of cumulative tobacco use (1 NY=9.125 kg of cumulative tobacco use). DEFINITIONS: Large airway obstructive ventilatory defect (OVD): forced expired volume in one second (FEV(1))/forced vital capacity (FVC) less than lower limit of normal (LLN). Small airway OVD: FVC more than LLN and decrease (less than LLN) of one or more peripheral flows. RVD: total lung capacity (TLC) less than LLN. SHI: residual volume (RV) more than upper limit of normal. SPIROMETRIC MEASURES: (Vmax 22 Series/6200 Autobox, SensorMedics, Yorba Linda, California, USA with measurement of functional residual capacity by nitrogen washout). Measurements were made according to international recommendations. RESULTS: One hundred and ten narghile smokers were included (34±10 years; 1.76±0.07m; 84±14kg). Thirty-six percent of the subjects had SHI; 14% had small airway OVD; 14% had RVD, and 6% had large airway OVD. Estimated lung age was higher than chronological lung age (47±18 years vs. 34±10 years, P<0.05). CONCLUSION: Narghile use accelerates lung ageing. This study provides the health authorities with valid arguments to fight this blight on society, which increasingly involves children and pregnant women.
Assuntos
Obstrução das Vias Respiratórias/fisiopatologia , Nebulizadores e Vaporizadores , Fumar/fisiopatologia , Espirometria , Adulto , Envelhecimento , Obstrução das Vias Respiratórias/etiologia , Índice de Massa Corporal , Estudos Transversais , Desenho de Equipamento , Humanos , Pulmão/patologia , Pulmão/fisiopatologia , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Fumaça/análise , Fumar/efeitos adversos , Fumar/tendências , Inquéritos e Questionários , Nicotiana/química , Tunísia , Adulto JovemRESUMO
Patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) treated by continuous positive airway pressure (CPAP) need to use long-term CPAP to prevent cardiovascular disease. The method of survival analysis was used to allow for long-term CPAP use in 72 patients who were prescribed a CPAP. During a mean follow-up of 22+/-15 months, one patient died and 17 patients stopped their treatment, 29% of them in the first 6 months. In compliant patients, the median value of daily CPAP use was 4.5hours. Kaplan Meier analysis showed that 92% of patients were still using CPAP at 6 months, 83% at 12 months and 59.9% at 3 years. Chronic obstructive pulmonary disease was identified as a predictor factor of long-term CPAP use (OR=4.53, p=0.01). CPAP is a well-accepted long-term therapy for OSAHS with 60% of patients continuing to be compliant with treatment at 3 years.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos , Cooperação do Paciente , Apneia Obstrutiva do Sono/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologiaRESUMO
INTRODUCTION: Studies of the spirometric profile of narghile smokers are few, have some methodologic limits (ie. small sample size) and present contradictory conclusions. OBJECTIVE: (i) To determine the percentage of smokers having an obstructive ventilatory defect (OVD) and/or a restrictive ventilatory defect (RVD) or static hyperinflation (SHI). (ii) To compare the chronological and the estimated lung ages. INCLUSION CRITERIA: men aged 20-60 years smoking narghile (>1 narghile-year (NA). Non-inclusion criteria: cigar or cigarettes smoker and co-morbidity. Narghile consummation quantification: NA and kg of cumulated tobacco (1 NA=9.125 kg of cumulated tobacco). DEFINITIONS: large airway OVD: FEV1/FVC
Assuntos
Pneumopatias Obstrutivas/epidemiologia , Fumar/epidemiologia , Espirometria , Adulto , Humanos , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Tunísia/epidemiologiaRESUMO
Pneumonia caused by varicella infection is a serious and severe complication of the disease when it occurs in adults. The authors report two cases of a varicella pneumonia in a 36 and a 41 year-old non-immunocompromised man. They were admitted to hospital for acute respiratory failure, not requiring intensive care, associated with exanthema. High resolution CT revealed well-defined diffuse nodules throughout both lungs, nodules with a surrounding halo of ground-glass opacity. Thrombocytopenia, hepatic cytolysis and an increase in lacticodeshydrogenase were noted. The patients made a full recovery with anti-viral therapy and oxygen therapy. Varicella pneumonia is the most common complication of varicella in adults. Anti-viral treatment is usually successful.
Assuntos
Varicela/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Adulto , Antivirais/uso terapêutico , Humanos , Imunocompetência , Masculino , Oxigenoterapia , Pneumonia Viral/terapia , Insuficiência Respiratória/virologiaRESUMO
Even in endemic countries, the primitive pleural hydatid cyst is exceptionnal and it's very difficult to distinguish from other pleural and parietal cystic masses all the more the immunologic tests are negative. We report the case of a primitive pleural hydatid cyst diagnosed in 43 years old man. Throug this case, imaging features are emphasized.
Assuntos
Equinococose Pulmonar/diagnóstico , Adulto , Diagnóstico por Imagem , Humanos , MasculinoRESUMO
INTRODUCTION: There is no clear consensus as to what constitutes an obstructive ventilatory defect (OVD). According to the American Thoracic Society and European Respiratory Society, it is defined as being when the ratio of the forced expiratory volume (FEV1) and the slow expiratory vital capacity (VC) is below the lower limit of normal (LLN). According to the Global initiative for chronic Obstructive Lung Disease and the British Thoracic Society, it is an FEV1/forced expiratory vital capacity (FVC)<0.70 and an FEV1<80%. In addition, in daily practice, the OVD is diagnosed by a "Fixed ratio" FEV1/FVC<0.70 orAssuntos
Pneumopatias Obstrutivas/diagnóstico
, Estudos Transversais
, Humanos
, Medidas de Volume Pulmonar
, Masculino
, Pessoa de Meia-Idade
, Pletismografia
, Fumar/efeitos adversos
, Sociedades Médicas
, Inquéritos e Questionários
RESUMO
INTRODUCTION: There is no clear consensus about what constitutes reversibility of airway obstruction. European Respiratory Society (ERS): Increase in FEV1 and/or FVC>12% of their theoretical value and>0.2l. British Thoracic Society: FEV1>15% of initial value and FEV1>0.2l. Global Initiative for Chronic Obstructive Lung Disease: Increase in FEV1>12% and>0.2l. Australia and New Zealand Thoracic Society: Increase in FEV1 >15%. American Thoracic Society/ERS: Increase in FEV1>12% and>0.2l or increase in FVC>12% and 0.2l. Our principal objective was to determine the percentage of patients with COPD (n=62) who were significant responders to the reversibility test according to the 5 recommendations. METHODS: Plethysmography was performed before and 15 minutes after inhalation of 400 micrograms of a short acting bronchodilator (BD). COPD is defined as a FEV1/FVC post BD<0.7. RESULTS: The percentage of responders varied from 24% to 50% depending on the recommendations used. CONCLUSION: Reversibility of airway obstruction is recommendation dependent.
Assuntos
Testes de Provocação Brônquica , Broncodilatadores , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Broncodilatadores/uso terapêutico , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Doença Pulmonar Obstrutiva Crônica/classificação , Testes de Função Respiratória , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
The tubercular pneumothorax is a rare and severe form of tuberculosis which persists in Tunisia. We reviewed retrospectively our experience at the Pneumology-Allergology Department of the Sousse Hospital with 23 cases of tubercular pneumothorax observed between 1985 and 2003. The suggestive symptom, pneumothorax, always occurred within a context poor general health and fever. The chest roentgengraph showed pneumothorax (n=8) or hydropneumothorax (n=15), and pulmonary lesions associated in 82.5% of patients. Bacteriological proof was obtained in 21 cases; in the two other patients, histological examination of the surgical specimen was highly suggestive of tuberculosis. Treatment associated antitubercular chemotherapy in compliance with the National Plan of against Tuberculosis (n=23), chest drainage (n=21) and respiratory physiotherapy (n=18). Five patients underwent surgery: pleural decortications (n=3), pulmonary resections (n=2). Two were lost to follow-up. The course was favourable in 78% of patients; there were two cases of partitioned pyopneumothorax and one post-operative death. In our experience, tubercular pneumothorax was always associated with active cavitated tuberculosis. The course was almost favorable with antitubercular chemotherapy and chest drainage.
Assuntos
Pneumotórax/complicações , Tuberculose Pulmonar/complicações , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/terapia , Estudos Retrospectivos , Tuberculose Pulmonar/terapia , TunísiaRESUMO
INTRODUCTION: Mucormycosis is a rare, devastating, fungal infection, which disproportionately affects non-controlled diabetic patients, notably during ketoacidosis. It can be manifested in rhinocerebral, but also pulmonary and disseminated forms. OBSERVATIONS: Four consecutive diabetic patients who were admitted to the Farhat Hached Hospital, Sousse, Tunisia, between January 2001 and November 2002, are presented. Three patients exhibited ketoacidosis and one renal failure with hyperosmolarity. Infection was limited to the sinuses in two cases, to lower respiratory tract in one case, and was probably disseminated in one case. Diagnosis was confirmed by mycological and histological findings in all cases. Systemic Amphotericin B was associated with surgical debridement of the lesions in patients with rhinocerebral involvement. DISCUSSION: Despite aggressive therapy, mortality was high (3 out of 4 patients). Mucormycosis remains a severe, frequently fatal disease in diabetic patients.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Mucormicose/etiologia , Mucormicose/patologia , Adolescente , Adulto , Idoso , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Desbridamento , Evolução Fatal , Feminino , HumanosRESUMO
We report the case of a 15-year-old girl with osteosarcoma in the left distal femur who developed a recurrent spontaneous pneumothorax. The patient was treated by neoadjuvant chemotherapy followed by surgery (limb-sparing surgical procedure with insertion of a knee prosthesis) and then adjuvant chemotherapy. The initial extension assessment was normal. No pulmonary metastasis was found. The chest tomography performed at the end of treatment (8 months after surgery) revealed two peripheral pulmonary nodules not seen on the chest X-ray. Palliative chemotherapy was given, the thoracic tomography after four chemotherapy courses showed a progress of the pulmonary metastasis and on the right more abundant bilateral pneumothorax which had recurred two months after thoracic draining. Thoracoscopy showed no pleural lesions.
Assuntos
Neoplasias Ósseas/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/secundário , Osteossarcoma/complicações , Osteossarcoma/secundário , Pneumotórax/etiologia , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/cirurgia , Feminino , Fêmur/patologia , Humanos , Osteossarcoma/tratamento farmacológico , Osteossarcoma/cirurgia , Cuidados Paliativos , RecidivaRESUMO
We report the case of a 42-year-old woman operated for neurofibroma of the scalp on two occasions who consulted for bilateral chest pain which reveated two voluminous bilateral pulmonary masses. Biopsy of one of these masses was in favor of secondary or primary leiomyosarcoma. The association of Von Recklinghausen's disease and soft tissue sarcoma is rare: most often neurofibroma which degenerates is observed. Other types of sarcoma, like leiomyosarcoma, have been described.
Assuntos
Leiomiossarcoma/patologia , Neoplasias Pulmonares/patologia , Neurofibromatose 1/patologia , Adulto , Biópsia , Dor no Peito/etiologia , Comorbidade , Feminino , Lateralidade Funcional , Humanos , Leiomiossarcoma/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Segunda Neoplasia Primária , Neurofibromatose 1/cirurgia , Radiografia Torácica , Couro Cabeludo/patologia , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Allergy skin tests are an important tool in the diagnosis of allergy diseases. They are useful in epidemiologic studies. OBJECTIVES: The aim of our study is to estimate the prevalence of the skin sensitivity in a sample of unselected population and to study the relationship between skin test reactivity and clinical manifestations. PATIENTS AND METHODS: During 9 months, we undertake skin prick-test in 500 subjects. Our population was recruited in the blood sample room of the biochemistry laboratory of the University Hospital of Sousse. Seven aeroallergen was tested: Dermatophagoïdes pteronyssinus (DPT), Dermatophagoïdes farinae (DF), Pollens of Graminees, Olive-tree, Partetaure, Cockroach and Candidine. A positive and a negative control tests were made. RESULTS: 34% of the population was sensitized to one or more aeroallergens. In the litterature this prevalence vary from 9 to 55.5% according to the methodology applied. In our study the skin reactivity does not change with sex (p = 0.26) but was high in subjects aged between 15 and 35 years. 21.8% were sensitized to house dust mites (DPT, DF) and 18.2% to pollens (Olive-tree, Graminees, Parietaire). Skin reactivity was more common when subjects had personal atopic history (p < 0.003) and/or had actual allergic symptoms particularyrhinitis and asthma (p < 0.006). CONCLUSION: Skin reactivity to common aeroallergens is frequent in the general population, particularly in symptomatic subjects affected by rhinitis and/or allergic asthma. This skin sensitization is the result of genetic and environmental interaction, but skin sensitization does not mean allergy.
Assuntos
Alérgenos/efeitos adversos , Dermatite de Contato/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alérgenos/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Testes Cutâneos , Tunísia/epidemiologiaRESUMO
Invasive pulmonary aspergillosis (IPA) remains a life threatening complication in immuno-compromised and especially in neutropenic patients. We report our experience in the diagnosis and therapeutic management of IPA in 8 patients with acute leukemia. All patients were neutropenic (PNN < 100/mm3, mean duration = 37 days) when IPA was diagnosed. Clinical signs included fever above 39 degrees and cough in all cases, chest pain in 4 cases, hemoptysis in 3 cases, rales in 5 cases. Chest x ray showed one lesion in 4 cases and multiple lesions in 4 cases. The diagnosis of IPA was established by bronchoalveolar lavage (BAL) in 5 cases, tissue biopsy in one case, positive sputum in one case and it was highly probable in one case. Thoracic computed tomographic (CT) scans were preformed after diagnosis confirmation of IPA and showed one or multiple lesions with air crescent signs. Serological tests were positive in 4 cases late in the course of IPA. All patients were treated with i.v. Amphotericin B. Outcome was favorable in 5 cases and three patients died by massive hemoptysis (in two cases) and systemic aspergillosis (in one case). Early diagnosis and appropriate treatment are essential to improve IPA prognosis.
Assuntos
Aspergilose/etiologia , Leucemia Mieloide Aguda/complicações , Pneumopatias Fúngicas/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Adulto , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Feminino , Humanos , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
A mediastinal hydatid cyst is rare (< 0.1% of hydatidosis). It most frequently progresses to calcification rather than a pulmonary hydatid cyst because there is no relationship to ventilation. We report a case of calcified mediastinal hydatid cyst which was confirmed on histological examinations from the operative specimen, in an agricultural worker of 58 who presented with a homolateral paralysed diaphragm.
Assuntos
Doenças dos Trabalhadores Agrícolas/parasitologia , Calcinose/complicações , Equinococose/complicações , Doenças do Mediastino/complicações , Paralisia Respiratória/parasitologia , Biópsia , Calcinose/diagnóstico , Calcinose/cirurgia , Equinococose/diagnóstico , Equinococose/cirurgia , Humanos , Masculino , Doenças do Mediastino/diagnóstico , Doenças do Mediastino/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We report a case of 33 year old man who consulted us in 1994 for recurrent bronchitis sometimes with haemoptysis. The physical examination was unremarkable. At consultation abnormal fascicular sounds were noted at the left base. A chest x-ray showed hyperlucency of the left lung associated with a very small left hilar shadow. We considered the diagnosis of Mac Leod's syndrome after eliminating a proximal obstructive pathology and pulmonary embolus. Mac Leod's syndrome or Swyer James' syndrome was described in 1954 and is suggested on the standard radiograph above all if the expiratory films have confirmed the presence of air trapping. Angiography shows a slender and fine pulmonary network. Computer tomographic examination of the chest rules out a bronchial tumour, excludes bullous emphysema and reveals hyperlucent zones. Scintigraphy with ventilation perfusion supplies the essentials to understanding the mechanism (a syndrome of aerated lung which is neither directly ventilated nor perfused). The expiratory function tests most often show a restrictive syndrome but sometimes an obstructive syndrome is found with associated air trapping. The disorder does not progress and the prognosis is good.
Assuntos
Pulmão Hipertransparente/diagnóstico , Adulto , Angiografia , Bronquite/diagnóstico , Broncoscopia , Diagnóstico Diferencial , Fluxo Expiratório Forçado , Hemoptise/diagnóstico , Humanos , Pulmão Hipertransparente/diagnóstico por imagem , Masculino , Prognóstico , Cintilografia , Tomografia Computadorizada por Raios X , Relação Ventilação-PerfusãoRESUMO
The frequency of tuberculous cerebral involvement associated with miliary tuberculosis is not well known; some authors have evaluated it at around 22%. We report the case of a 43-year-old man hospitalised in the pulmonology department with bacillary positive miliary tuberculosis. On the 26th day of antituberculosis treatment he complained of frontal headaches, with impairment in visual acuity. Examination of the optic fundus showed bilateral papillary oedema. Cerebral computed tomography showed diffuse rounded lesions with significant oedema. Antituberculosis chemotherapy was supplemented with steroid treatment. Clinical and radiological progress was good.
Assuntos
Tuberculoma Intracraniano , Tuberculose Miliar , Adulto , Antituberculosos/uso terapêutico , Cosintropina/uso terapêutico , Humanos , Masculino , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/diagnóstico por imagem , Tuberculoma Intracraniano/tratamento farmacológico , Tuberculose Miliar/diagnóstico por imagem , Tuberculose Miliar/tratamento farmacológicoAssuntos
Antituberculosos/farmacologia , Mycobacterium tuberculosis/efeitos dos fármacos , Adolescente , Adulto , Antibióticos Antituberculose/farmacologia , Resistência Microbiana a Medicamentos , Etambutol/farmacologia , Etionamida/farmacologia , Humanos , Isoniazida/farmacologia , Testes de Sensibilidade Microbiana , Rifampina/farmacologia , Estreptomicina/farmacologia , TunísiaRESUMO
During a 10-yr period, 386 patients with hydatid disease of the lung were treated at our hospital. There were 165 male and 221 female patients with a mean age of 30.15 + 16.9 yr. There were 286 solitary, 20 multiple, and 21 bilateral cysts. In 59 patients, the cysts included the lung and other organs; in 54, the lung and the liver; in four, the lung and the kidney; in one, the lung and the peritoneum. Diagnosis was made using clinical criteria, serologic findings, and imaging techniques; 373 patients were treated surgically. Surgical procedures consisted of cystectomy in 93 patients, pericystectomy in 166 patients, and lung resection in 114 patients. Mebendazole and flubendazole were used in three patients. Postoperative complications occurred in 44 patients (15.8%). There were two operative deaths (mortality rate, 0.53%). Patients have been followed yearly, with a median follow-up of 6 yr. Active hydatid disease has been found in two patients.