Surgery for aspergilloma: time trend towards improved results?

Area of Science:

• Pulmonology
• Thoracic Surgery
• Infectious Diseases

Background:

• Surgery for pulmonary aspergilloma presents significant technical challenges and high complication rates.
• Previous studies indicated improved outcomes correlating with a decrease in complex cases, particularly those with a history of tuberculosis.
• This study investigates the continuation of this positive time trend in recent surgical practice.

Purpose of the Study:

• To evaluate the trends in surgical treatment outcomes for pulmonary aspergilloma.
• To compare recent patient outcomes with historical data, focusing on complication rates and underlying disease complexity.
• To assess the safety and efficacy of contemporary aspergilloma resection.

Main Methods:

• Retrospective review of 33 patients who underwent surgical treatment for aspergilloma between 1998 and 2009.
• Comparison of these recent cases with two prior patient cohorts (1974–1991 and 1992–1997).
• Analysis of initial presentation, underlying diseases (especially tuberculosis), and postoperative outcomes, including mortality and morbidity.

Main Results:

• A notable decrease in tuberculosis as the underlying disease (15% in the recent group vs. 57% and 17% in prior groups).
• Significant reduction in complex aspergillomas (12% in the recent group vs. 80% and 41% in prior groups).
• Zero postoperative mortality in the recent cohort, with progressive decreases in bleeding (6%), pleural space problems (12%), and prolonged hospital stay (6%) compared to earlier groups.

Conclusions:

• Contemporary surgical resection of pulmonary aspergilloma is associated with significantly reduced postoperative complications.
• The observed time trend of improved outcomes, linked to fewer complex cases and tuberculosis history, has continued.
• Current surgical approaches for aspergilloma are safe and yield satisfactory short- and long-term results.