Surgical management of pulmonary aspergilloma: clinical experience with 77 cases

Background/aim: This retrospective study evaluated the clinical presentation, underlying lung disease, surgical indications, technique, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methods: We evaluated 77 patients who underwent pulmonary resection of an aspergilloma at Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital between January 2000 and December 2013. The initial operations were 4 pneumonectomies, 24 lobectomies, 9 lobectomy plus myoplasties, 10 segmental resections, and 30 wedge resections. Six reoperations were carried out to deal with postoperative complications: 1 myoplasty, 2 completion lobectomies plus myoplasties, 2 myoplasties with rib resections, and 1 completion lobectomy. Results: The subjects comprised 53 males (mean age: 44.26 (range: 10?73) years) and 24 females (mean age: 48.25 (range: 26?70) years). The most common indication for surgery was hemoptysis in 52 patients (67.53%). The most common underlying lung disease was tuberculosis in 37 patients (48.05%). Forty patients (51.94%) had a simple pulmonary aspergilloma and 37 (48.05%) had a complex pulmonary aspergilloma. Major complications occurred in 18 patients (23.37%). The postoperative mortality rate was 3.89%, with 3 patients dying. Conclusion: Surgical resection of pulmonary aspergilloma is the best way to prevent recurrent hemoptysis with low morbidity and mortality
Anahtar Kelimeler:

Aspergilloma, surgery, complication

Surgical management of pulmonary aspergilloma: clinical experience with 77 cases

Background/aim: This retrospective study evaluated the clinical presentation, underlying lung disease, surgical indications, technique, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methods: We evaluated 77 patients who underwent pulmonary resection of an aspergilloma at Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital between January 2000 and December 2013. The initial operations were 4 pneumonectomies, 24 lobectomies, 9 lobectomy plus myoplasties, 10 segmental resections, and 30 wedge resections. Six reoperations were carried out to deal with postoperative complications: 1 myoplasty, 2 completion lobectomies plus myoplasties, 2 myoplasties with rib resections, and 1 completion lobectomy. Results: The subjects comprised 53 males (mean age: 44.26 (range: 10?73) years) and 24 females (mean age: 48.25 (range: 26?70) years). The most common indication for surgery was hemoptysis in 52 patients (67.53%). The most common underlying lung disease was tuberculosis in 37 patients (48.05%). Forty patients (51.94%) had a simple pulmonary aspergilloma and 37 (48.05%) had a complex pulmonary aspergilloma. Major complications occurred in 18 patients (23.37%). The postoperative mortality rate was 3.89%, with 3 patients dying. Conclusion: Surgical resection of pulmonary aspergilloma is the best way to prevent recurrent hemoptysis with low morbidity and mortality

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  • Brik A, Salem AM, Kamal AR, Sadek MA, Sharawy ME, Essa M, Deebes A, Bary KA. Surgical outcome of pulmonary aspergilloma. Eur J Cardiothorac Surg 2008; 34: 882–885. 2. Demir A, Gunluoglu MZ, Turna A, Kara H, Dincer SI. Analysis of surgical treatment for pulmonary aspergilloma. Asian Cardiovasc Thorac Ann 2006; 14: 407–411.
  • Lee SH, Lee BJ, Jong DY, Kim JH, John DS, Shin JW. Clinical manifestation and treatment outcomes of pulmonary aspergilloma. Korean Journal Of Internal Medicine 2004; 19: 36–42.
  • Farid S, Mohamed S, Devbhandari M, Kneale M, Richardson M, Soon SY, Jones MT, Krysiak P, Shah R, Denning DW et al. Results of surgery for chronic pulmonary aspergillosis, optimal antifungal therapy and proposed high risk factors for recurrence - a National Centre’s experience. J Cardiothorac Surg 2013; 8: 180.
  • Daly RC, Pairolero PC, Piehler JM, Trastek VF, Payne WS, Bernatz PE. Pulmonary aspergilloma (results of surgical treatment). J Thorac Cardiovasc Surg 1986; 92: 981–988.
  • Massard G, Roeslin N, Wihlm JM, Dumont P, Witz JP, Morand G. Pleuropulmonary aspergilloma: clinical spectrum and results of surgical treatment. Ann Thorac Surg 1992; 54: 1159– 1164.
  • Akbari JG, Varma PK, Neema PK, Menon MU, Neelakandhan KS. Clinical profile and surgical outcome for pulmonary aspergilloma: a single center experience. Ann Thorac Surg 2005; 80: 1067–1072.
  • Lejay A, Falcoz PE, Santelmo N, Helms O, Kochetkova E, Jeung M, Kessler R, Massard G. Surgery for aspergilloma: time trend towards improved results? Interact Cardio Vasc Thorac Surg 2011; 13: 392–395.
  • Unis G, Picon PD, Severo LC. Coexistence of intracavitary fungal colonization (fungus ball) and active tuberculosis. J Bras Pneumol 2005; 31: 139–143.
  • Lachanas E, Tomos P, Fotinou M, Kalokerinou K. An unusual pulmonary cavitating lesion. Respiration 2005; 72: 657–659.
  • Kim YT, Kang MC, Sung SW, Kim JH. Good long term outcomes after surgical treatment of simple and complex pulmonary aspergilloma. Ann Thorac Surg 2005; 79: 294–298.
  • Kurul IC, Demircan S, Yazici U, Altinok T, Topcu S, Unlü M. Surgical management of pulmonary aspergilloma. Asian Cardiovasc Thorac Ann 2004; 12: 320–323.
  • Battaglini JW, Murray GF, Keagy BA, Starek PJK, Wilcox BR. Surgical management of symptomatic pulmonary aspergilloma. Ann Thorac Surg 1985; 39: 512–516.
  • Dakak M, Genç O, Gürkök S, Gözübüyük A, Balkanlı K. Pulmonary aspergilloma; Türk Göğüs Kalp Damar Cerrahisi Dergisi 1999; 7: 480–482 (in Turkish with English abstract).
  • Koşlar A, Kıral H, Orki A, Keleş M, Ürek Ş, Temürtürkan K, Dudu C, Arman B. Surgical approach to pulmonary aspergilloma. Toraks Dergisi 2005; 6: 1–7.
  • Hammoumi M, Traibi A, Oueriachi FE, Arsalane A, Kabiri EH. Surgical treatment of aspergilloma grafted in hydatid cyst cavity. Rev Port Pneumol 2013; 19: 281–283.
  • Chen QK, Jiang GN, Ding JA. Surgical treatment for pulmonary aspergilloma: a 35-year experience in the Chinese population. Interact Cardiovasc Thorac Surg 2012; 15: 77–80.
  • Cıtak N, Sayar A, Metin M, Pekçolaklar A, Kök A, Fener NA, Çelikten A, Gürses A. Results of surgical treatment for pulmonary aspergilloma with 26 cases in six years: a single center experience. Tuberk Toraks 2011; 59: 62–69 (in Turkish with English abstract).
  • Chen JC, Chang YL, Luh SP, Lee JM, Lee YC. Surgical treatment for pulmonary aspergilloma: a 28 year experience. Thorax 1997; 52: 810–813.
  • Babatasi G, Massetti M, Chapelier A, Fadel E, Macchiarini P, Khayat A, Dartevelle P. Surgical treatment of pulmonary aspergilloma: current outcome. J Thorac Cardiovasc Surg 2000; 119: 906–912.
  • Pecora DV, Toll MW. Pulmonary resection for localized aspergillosis. N Engl J Med 1960; 263: 785–787.
  • Garvey J, Crastnopol P, Weisz D, Khan F. The surgical treatment of pulmonary aspergillomas. J. Thorac Cardiovasc Surg 1977; 74: 542–547.
  • Kay PH. Surgical management of pulmonary aspergilloma. Thorax 1997; 52: 753–754.
  • Solit RW, McKeown JJ, Smulens S, Fraimo W. The surgical implication of intracavitary mycetomas (fungus ball). J Thorac Cardiovascular Surg 1971; 62: 411–422.
  • Regnard JF, Icard P, Nicolosi M, Spagiarri L, Magdeleinat P, Jauffret B, Levasseur P. Aspergilloma: a series of 89 surgical cases. Ann Thorac Surg 2000; 69: 898–903.
  • Şanlı M, Tunçözgür B, Sivrikoz C, Dikensoy Ö, Elbeyli L. Pulmoner aspergilloma. Tuberk Toraks 2002; 50: 70–73 (in Turkish with English abstract).
  • Oakley RE, Petrou M, Goldstraw P. Indications and outcome of surgery for pulmonary aspergilloma. Thorax 1997; 52: 813– 815.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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