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Pulmonary aspergilloma--indications for surgical intervention. An analysis of 22 cases
Abstract:
Surgical resection of aspergillomas has generally been associated with excess mortality and morbidity; 22 patients who had a resection of complicated mycetomas were studied retrospectively. Indications for surgery were serious haemoptysis (14), massive haemoptysis (6), and recurrent infection (2). Extrapleural pneumonectomy was required in 9 patients and extrapleural lobectomy in 12; thoracoplasty alone was done in 1 patient. There was 1 hospital death (4.5%); 4 patients developed postoperative empyemas (18%), 2 with associated bronchopleural fistulas. Two further patients (9%) had stable postresectional spaces. Surgery for complicated aspergilloma was associated with significant postoperative morbidity.
Insights
Surgical resection of complicated aspergillomas carries significant risks. This study found a 4.5% hospital mortality and high rates of postoperative complications like empyema.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Infectious Diseases
Background:
- Aspergillomas, fungal infections in the lungs, often require surgical intervention.
- Surgical resection of these fungal balls has historically been linked to high rates of mortality and morbidity.
Purpose of the Study:
- To retrospectively analyze the outcomes of surgical resection for complicated aspergillomas.
- To identify the indications for surgery and the associated postoperative complications.
Main Methods:
- Retrospective review of 22 patients who underwent surgical resection for complicated aspergillomas.
- Analysis of surgical procedures (extrapleural pneumonectomy, extrapleural lobectomy, thoracoplasty) and patient outcomes.
Main Results:
- The primary indications for surgery were severe or massive hemoptysis and recurrent infections.
- One hospital death (4.5%) occurred. Postoperative complications included empyema (18%), bronchopleural fistulas (9%), and stable postresectional spaces (9%).
Conclusions:
- Surgical resection for complicated aspergillomas is associated with substantial postoperative morbidity.
- Careful patient selection and management are crucial due to the inherent risks of surgical intervention.