Complex pulmonary aspergilloma treated by cavernostomy

Abstract

Results Results: Ten patients were male. The mean age was 42.9 years (34-56). The most frequent symptom was repeated pulmonary bleeding. Cavernostomy was proposed for patients at high risk for lung resection. It was performed in 17 patients and all of them had pulmonary tuberculosis sequelae, with cavitations. The indication in all cases was hemoptysis and elimination of phlegm. The cavernostomies were performed in a single surgical procedure. In all 17 patients the cavity was left open after the withdrawal of the mycetoma. In all patients hemoptysis ceased immediately. Operative mortality was 9.5% (1). Conclusion Conclusion Conclusion Conclusion Conclusion: cavernostomy is an effective treatment alternative in patients at high risk. It may be useful in some patients with complex aspergilloma, irrespective of lung function or bilateral disease. It is technically easy, has low-risk, saves parenchyma, and may be performed in a single operative time.

Surgical Outcome of Chronic Pulmonary Aspergilloma: An Experience from Two Tertiary Referral Hospitals in Addis Ababa, Ethiopia

“…Cavernostomy was done primarily for either peripheral placed small PA or when the fungal ball lies close to the fissure or hilum and pneumonectomy was not an option because of the patient's general condition. Similar to other studies, (19)(20)(21)(28)(29)(30)(31)(32), the postoperative complications related to it were significantly low (P=0.011). Cavernostomy is now considered as a viable treatment alternative even to those that can be submitted to pulmonary resection.…”

“…Previous studies reported operative mortality rates to range from 4 to 22%, (34)(35)(36)(37) and postoperative complications of 15-78%, (28) with the current surgical and anesthetic advances; recent reports show an improved outcome (34). Several of such series describe acceptable outcomes with 2 to 5% mortality and 25% overall complication rate (28)(29)(30)(31)(32)(33)(34)(35) Overall, the result of this study is equally favorable to other recent results.…”

“…The British Thoracic and Tuberculosis Association reported 6% of patients with a healed tuberculosis cavity developing pulmonary aspergilloma within 3 years (17). Many studies also showed pulmonary tuberculosis as the most common pre-existing cavity lesion accounting for 32-45% (28,29). Chen QK from China reported that 71.1% of their patients with PA were treated for tuberculosis (9).…”

Hemoptysis from complex pulmonary aspergilloma treated by cavernostomy and thoracoplasty

“…Another study showed that the mortality rate was variants from one in 17 patients to 4 in nine patients. The reasons behind this may be that the number of patients was small, and the experience of the surgeon may be a lack in this type of surgery [12, 37]. In low-resource countries, surgery for CPA was very challenging, but it was the best treatment modality for symptomatic patients [38].…”

“…It also was an effective therapy in high-risk patients such as pulmonary function insufficiency, poor general condition, bilateral disease, complex pulmonary aspergilloma [5, 6, 11–13]. Cavernostomy was less invasive procedures with the technically easy, simple and effective procedure, with many advantages [12, 14, 15]. But the cavity that formed after cavernostomy may lead to recurrence.…”