Fungus ball removal with video-cavernoscopy for complex aspergilloma

Area of Science:

• Pulmonology
• Thoracic Surgery
• Interventional Pulmonology

Background:

• Complete resection is the only curative treatment for pulmonary aspergilloma.
• Complex aspergilloma (CA) presents surgical challenges due to patient conditions and adhesions.
• Fungus ball removal via video-cavernoscopy is a palliative method for hemoptysis control.

Purpose of the Study:

• To evaluate video-cavernoscopic fungus ball removal as an alternative treatment for CA.
• To compare outcomes of video-cavernoscopic removal with one-stage radical surgery.

Main Methods:

• Retrospective review of 8 cases of video-cavernoscopic removal.
• Comparison of patient characteristics and surgical outcomes with 25 patients undergoing one-stage radical surgery.

Main Results:

• The video-cavernoscopic group had higher rates of emphysematous lung, lower BMI, and lower vital capacity.
• All patients in the video-cavernoscopic group experienced cessation of hemoptysis post-procedure.
• Video-cavernoscopic removal was less invasive (shorter operative time, less blood loss, lower complication grade).
• 50% of patients in the video-cavernoscopic group experienced relapse with a median disease-free survival of 471.5 days.

Conclusions:

• Video-cavernoscopic fungus ball removal is a simple technique for preventing and controlling massive hemoptysis in CA.
• This method may serve as an alternative treatment option for complex aspergilloma.