Surgical management of pulmonary aspergilloma

Kay, P H

doi:10.1136/thx.52.9.753

Cited by 19 publications

(18 citation statements)

References 17 publications

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“…Other studies also identified tuberculosis as the underlying disease [4,7-9,12,17,21,28,32]. Interestingly, sarcoidosis was not detected in any patient as the underlying disease, in contrast to other reports [2,33].…”

Section: Resultsmentioning

confidence: 61%

Cavernostomy x Resection for Pulmonary Aspergilloma: A 32-Year History

Cesar

Resende

Amaral

et al. 2011

J Cardiothorac Surg

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BackgroundThe most adequate surgical technique for the treatment of pulmonary aspergilloma is still controversial. This study compared two groups of patients submitted to cavernostomy and pulmonary parenchyma resection.MethodsCases of pulmonary aspergilloma operated upon between 1979 and 2010 were analyzed retrospectively. Group 1 consisted of patients submitted to cavernostomy and group 2 of patients submitted to pulmonary parenchyma resection. The following variables were compared between groups: gender, age, number of hospitalizations, pre- and postoperative length of hospital stay, time of follow-up, location and type of aspergilloma, preoperative symptoms, underlying disease, type of fungus, preoperative pulmonary function, postoperative complications, patient progression, and associated diseases.ResultsA total of 208 patients with pulmonary aspergilloma were studied (111 in group 1 and 97 in group 2). Group 1 was older than group 2. The number of hospitalizations, length of hospital stay and time of follow-up were higher in group 1. Hemoptysis was the most frequent preoperative symptom in group 1. Preoperative respiratory malfunction was more severe in group 1. Hemorrhagic complications and recurrence were more frequent in group 1 and infectious complications and residual pleural space were more common in group 2. Postoperative dyspnea was more frequent in group 2. Patient progression was similar in the two groups. No difference in the other factors was observed between groups.ConclusionsOlder patients with severe preoperative respiratory malfunction and peripheral pulmonary aspergilloma should be submitted to cavernostomy. The remaining patients can be treated by pulmonary resection.

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Section: Resultsmentioning

confidence: 61%

Cavernostomy x Resection for Pulmonary Aspergilloma: A 32-Year History

Cesar

Resende

Amaral

et al. 2011

J Cardiothorac Surg

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“…The airborne method of spread and chronic underlying pathology led to fungus ball developing in individual patients. 4 The British Thoracic and Tuberculosis Association reported 6% of patients with open healed tuberculous cavity developing an aspergilloma within three years. 9 Our patients had a history of tuberculosis ranging from 2 to 20 years (average 8.2 years) before surgery, similar to the fi ndings reported by Tseng and colleagues.…”

Section: Discussionmentioning

confidence: 99%

“…Medical treatment has little role in the management and surgery offers signifi cant benefi ts for the patient. 4 However, high mortality and morbidity rates of the operation have been reported in literature. [5][6][7] The purpose of this study was to evaluate patient data, operative techniques and results in the surgical management of pulmonary cavity associated with fungus ball.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Pulmonary Cavity Associated with Fungus Ball

Rergkliang

Chetpaophan

Chittithavorn

et al. 2004

Asian Cardiovasc Thorac Ann

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Surgery for pulmonary cavity associated with fungus ball is challenged by chronic lung disease. The purpose of this report was to review patient data, operative procedures and results of surgery. This was a retrospective study. Twenty patients were operated on between January 1997 and December 2002. Fourteen (70%) patients were male and the mean age was 46.30 +/- 13.10 years (range, 24 to 76 years). The most common underlying pulmonary disorder was tuberculosis (70%). Ninety five percent of the patients had a history of hemoptysis, and 35% presented with massive hemoptysis. Lobectomy was performed in 11 (55%) patients and 6 (30%) patients were operated on by cavernostomy with transposition of muscle flap technique. There was no operative mortality and 8 complications (3 prolonged airleaks, 2 wound infections, 1 postoperative bleeding, 1 seroma and 1 empyema). It was also found that emergency surgery and cavernostomy with transposition of muscle flap compromised the postoperative course. Surgery is very effective in controlling and preventing hemoptysis in patients who have pulmonary cavity associated with fungus ball. Elective surgery and formal pulmonary resection may be the proper option for low risk patients. Cavernostomy with transposition of muscle flap may be suitable for patients who have poor pulmonary reserve.

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“…11 Oral, intravenous and trans-cavitatory instillation of antifungal drugs have limited success rate. 12 Simple aspergilloma is amenable to surgery and has low operative risk, if good pulmonary reserve is present, prior to surgery, but complex aspergilloma results in maximum post-surgical complications and even death. 13 Preoperative pulmonary function test can indicate immediate outcome after surgery and on long term.…”

Section: Discussionmentioning

confidence: 99%