We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Surgical treatment for pulmonary aspergilloma -- early and long-term results.
- Authors
Kasprzyk, Mariusz; Pieczyński, Kornel; Mania, Krystian; Gabryel, Piotr; Piwkowski, Cezary; Dyszkiewicz, Wojciech
- Abstract
Introduction: Pulmonary aspergilloma is a difficult therapeutic problem due to the low effectiveness of conservative treatment and high surgical morbidity. Aim: To analyze the early and late results of surgical treatment for pulmonary aspergilloma. Material and methods: From 2005 to 2015, 49 patients were treated surgically for pulmonary aspergilloma. Symptoms occurred in 85.7% of cases, including recurrent hemoptysis in 53%. A history of immunosuppressive therapy or chemotherapy was noted in 24.5% of patients. Complex aspergilloma was diagnosed in 79.6% of cases. Immunological test results were positive in 10.2%, and bronchoalveolar lavage samples were positive for Aspergillus species in 18.5% of cases. In 59.2% of patients, the surgical risk was assessed as ASA 3. Thirty seven patients underwent lobectomy, 3 - pneumonectomy, 7 - wedge resection, 1 - decortication, and 1 - cavernostomy. Results: In-hospital mortality was 4.1%. Postoperative complications occurred in 63.3% of patients. The most common complications were: prolonged air leak (26.3%), arrhythmias (20.4%), residual pneumothorax (16.3%), respiratory failure (14.3%), atelectasis (12.3%), and bleeding (12.3%). Of the three patients that underwent pneumonectomy, one died, two required repeat thoracotomy because of bleeding, and all three required prolonged mechanical ventilation. Two patients died during the follow-up period. Aspergilloma did not recur in any of the patients who underwent pulmonary resection. Conclusions: Due to the high risk of complications, surgical treatment of pulmonary aspergilloma should be restricted to symptomatic patients in whom lobectomy can be performed. The long-term results of surgical treatment are good, preoperative symptoms abate in most patients, and the rate of aspergillosis recurrence is very low.
- Subjects
PULMONARY aspergillosis; SURGERY
- Publication
Polish Journal of Thoracic & Cardiovascular Surgery / Kardiochirurgia i Torakochirurgia Polska, 2017, Vol 14, Issue 2, p99
- ISSN
1731-5530
- Publication type
Article
- DOI
10.5114/kitp.2017.68738