Outcomes of resectable pulmonary aspergilloma and the performance gap in a high tuberculosis prevalence setting: A retrospective study

Masoud, SR; Irusen, E M; Koegelenberg, C F N; Preez, LJ du; Allwood, B W

doi:10.7196/sarj.2017.v23i1.154

Cited by 3 publications

(2 citation statements)

References 28 publications

(41 reference statements)

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“…[1] Moreover, in under-resourced, overburdened centres there may be a considerable delay between presentation and surgery, and patients with severe post-TB lung disease or other comorbidities may not be candidates for surgical intervention. [7] Several endovascular techniques have been reported for the treatment of PA aneurysms other than Rasmussen's, among these, the Amplatzer vascular plug (AVP; Abbott Laboratories, USA), shown in Fig. 1.…”

Section: In Practicementioning

confidence: 99%

Issues in Medicine

Shaw

John²,

Koegelenberg³

et al. 2023

S Afr Med J

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Rasmussen aneurysms are abnormalities of the pulmonary arterial system caused by tuberculosis (TB). They are associated with a highmortality rate when they cause life-threatening haemoptysis. High TB-prevalence regions have a large burden of TB-related haemoptysisbut often limited resources. This series of 25 patients who presented with life-threatening haemoptysis from current and/or previous TBwere found to have abnormal pulmonary arteries on computed tomography pulmonary angiogram (CTPA), which were judged to belikely contributors to their bleeding, either in isolation or with concomitant abnormal bronchial or systemic vasculature. These patientsunderwent transcatheter placement of Amplatzer vascular plugs in the feeder pulmonary artery. Bronchial and systemic lesions wereaddressed separately as needed. Immediate technical success was achieved in all patients, but four of them experienced intraoperativehaemoptysis related to dislodgement of the occluding platelet plug by the high-pressure automatic injector and wire. At 48 hours after theprocedure, 18 (72%) remained haemoptysis-free. Six of these experienced recurrence within 1 year of their procedure. Pulmonary arteryplacement of an Amplatzer vascular plug is a feasible option for treating bleeding Rasmussen aneurysms, but should be part of a combinedapproach to addressing suspected culprit vascular lesions in all intrathoracic vascular systems.

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Section: In Practicementioning

confidence: 99%

Issues in Medicine

Shaw

John²,

Koegelenberg³

et al. 2023

S Afr Med J

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“…(Table 1). Seventeen (41.5%) studies were retrospective chart reviews [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], 12 (29.3%) were case reports [29][30][31][32][33][34][35][36][37][38][39][40], 5 case series (12.2%) [8,[41][42][43][44], 5 prospective cohorts [45][46][47][48][49], and 2 cross-sectional studies [50,51]. The majority of the studies were from East (n = 11) and West (n = 10) Africa.…”

Section: Summary Of Studiesmentioning

confidence: 99%

Mapping of Chronic Pulmonary Aspergillosis in Africa

Olum

Osaigbovo

Baluku

et al. 2021

JoF

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Africa has a high burden of tuberculosis, which is the most important risk factor for chronic pulmonary aspergillosis (CPA). Our goal was to systematically evaluate the burden of CPA in Africa and map it by country. We conducted an extensive literature search for publications on CPA in Africa using the online databases. We reviewed a total of 41 studies published between 1976 and 2021, including a total of 1247 CPA cases from 14 African countries. Most of the cases came from Morocco (n = 764, 62.3%), followed by South Africa (n = 122, 9.9%) and Senegal (n = 99, 8.1%). Seventeen (41.5%) studies were retrospective, 12 (29.3%) were case reports, 5 case series (12.2%), 5 prospective cohorts, and 2 cross-sectional studies. The majority of the cases (67.1%, n = 645) were diagnosed in men, with a median age of 41 years (interquartile range: 36–45). Active/previously treated pulmonary tuberculosis (n = 764, 61.3%), human immunodeficiency virus infection (n = 29, 2.3%), diabetes mellitus (n = 19, 1.5%), and chronic obstructive pulmonary disease (n = 10, 0.8%) were the common co-morbidities. Haemoptysis was the most frequent presenting symptom, reported in up to 717 (57%) cases. Smoking (n = 69, 5.5%), recurrent lung infections (n = 41, 3%) and bronchorrhea (n = 33, 3%) were noted. This study confirms that CPA is common in Africa, with pulmonary tuberculosis being the most important risk factor.

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Surgical management of chronic pulmonary aspergillosis in Africa: A systematic review of 891 cases

Bongomin

Olum

Kwizera

et al. 2021

Mycoses

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Chronic pulmonary aspergillosis (CPA) is an emerging fungal infectious disease of public health importance. We conducted a systematic review of studies reporting the outcomes of patients with CPA managed surgically in Africa. A search of Medline, Embase, Web of Science, Google Scholar and African Journals Online was conducted to identify studies indexed from inception to June 2021 that examined surgical management of CPA in Africa. All articles that presented primary data, including case reports and case series, were included. We excluded review articles. A total of 891 cases (557 males (62.5%), mean age 39.3 years) extracted from 27 eligible studies published between 1976 and 2020 from 11 African countries were included. Morocco (524, 59%) and Senegal (99, 11%) contributed the majority of cases. Active or previous pulmonary tuberculosis was reported in 677 (76.0%) cases. Haemoptysis was reported in 682 (76.5%) cases. Lobectomy (either unilateral or bilateral, n = 493, 55.3%), pneumonectomy (n = 154, 17.3%) and segmentectomy (n = 117, 13.1%) were the most frequently performed surgical procedures. Thirty (4.9%) cases from South Africa received bronchial artery embolisation. Empyema (n = 59, 27.4%), significant haemorrhage (n = 38, 173.7%), incomplete lung expansion (n = 26, 12.1%) and prolonged air leak (n = 24, 11.2%) were the most frequent complications. Overall, 45 (5.1%) patients died. The causes of death included respiratory failure (n = 14), bacterial superinfection/sepsis (n = 10), severe haemorrhage (n = 5), cardiopulmonary arrest (n = 3) and complications of chronic obstructive pulmonary disease (n = 3). The cause of death was either unknown or unspecified in 9 cases. We conclude that surgical treatment had very low mortality rates and maybe considered as first‐line management option in centres with experience and expertise in Africa.

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Outcomes of resectable pulmonary aspergilloma and the performance gap in a high tuberculosis prevalence setting: A retrospective study

Cited by 3 publications

References 28 publications

Issues in Medicine

Issues in Medicine

Mapping of Chronic Pulmonary Aspergillosis in Africa

Surgical management of chronic pulmonary aspergillosis in Africa: A systematic review of 891 cases

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