Background: This study aims to evaluate the outcomes of the single-stage thoracotomy for hydatid cysts of the right lung and liver, left lung and spleen, and liver only and to investigate the diagnostic value of this approach.

Methods: Between January 1994 and December 2011, 290 patients (158 females, 132 males; mean age 32.2 years; range 5 to 74 years) who were operated using thoracic approach for hydatid cysts of the lung, liver, and spleen were retrospectively analyzed. The patients were assessed in terms of age, sex, symptoms, recurrence, whether the cyst ruptured or unruptured, operation type, length of hospital stay and postoperative complication rates. The most common symptom was the respiratory systemassociated complaints, while 25 patients were asymptomatic.

Results: A total of 280 patients underwent right posterolateral thoracotomy using transdiaphragmatic approach, whereas only 10 patients underwent left posterolateral thoracotomy through transdiaphragmatic approach. Among 331 surgeries, 43 complications (13.44%) were encountered. Postoperative atelectasis was present in 12 patients (27.9%), prolonged air leak in 13 patients (30.2%), biliary drainage from subdiaphragmatic drain in eight patients (18.6%), recurrence in five patients (11.6%), bronchobiliary fistula in five patients (11.6%), and empyema in three patients (6.9%). There was no intraoperative mortality.

Conclusion: In selected cases, the right lung-liver and the left lung-spleen hydatid cysts can be operated with a singlesession thoracotomy and transdiyafragmatic approach. This approach may rescue the patients from another operation and decrease the length of hospital stay and morbidity. Subdiaphragmatic liver cysts may cause many thoracic pathologies, passing through the diaphragm. Thoracic approach is more advantageous and suitable for such patients.

Keywords : Hydatid cysts; splenectomy; thoracic approach