Complex Pulmonary Aspergilloma: Surgical Challenges in a Third World Setting.

Area of Science:

• Thoracic surgery
• Infectious diseases
• Medical research in resource-poor settings

Background:

• Pulmonary aspergilloma (PA) presents significant surgical challenges, particularly complex cases, in resource-limited environments like Cameroon.
• This study details the experience of surgical PA management within such a setting.

Purpose of the Study:

• To evaluate the feasibility and outcomes of surgical intervention for pulmonary aspergilloma in a resource-poor setting.
• To assess the efficacy and safety of surgical treatment for complex PA in Cameroon.

Main Methods:

• Prospective assessment of 20 patients undergoing surgery for PA from January 2012 to May 2015 at the University Hospital Center of Yaoundé.
• Review of patient demographics, clinical presentation, radiological findings, surgical procedures, and postoperative outcomes.
• Ethical approval obtained from institutional ethics committees.

Main Results:

• Twenty patients (17 males, 3 females; mean age 30) with a history of tuberculosis were included.
• The primary symptoms were hemoptysis, cough, and chest pain; all patients underwent lung resection.
• Four patients experienced postoperative complications (bleeding, air leak, empyema, severe anemia), with one mortality. The survival rate was 80% after a median follow-up of 21.5 months, with symptom improvement.

Conclusions:

• Surgical treatment for complex pulmonary aspergilloma is feasible and effective, even in challenging resource-poor settings.
• Despite difficulties, surgery remains the preferred treatment for symptomatic PA in Cameroon.
• This experience highlights the potential for successful surgical management of PA in similar environments.