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Surgery for pulmonary aspergillosis
A Csekeo1, L Agócs, M Egerváry
1Koranyi National Institute, Thoracic Surgery Clinic and Pathology Department, Budapest, Hungary.
Summary
Surgical intervention for pulmonary aspergillosis can lead to complications. This study evaluates surgical outcomes for 84 patients, highlighting resection as a primary treatment for pulmonary aspergilloma.
Area of Science:
- Medical Mycology
- Thoracic Surgery
- Infectious Diseases
Background:
- Pulmonary aspergillosis presents a significant challenge, often associated with a high incidence of post-operative complications.
- Understanding surgical outcomes is crucial for managing this invasive fungal infection.
Purpose of the Study:
- To evaluate surgical outcomes and complications in patients with pulmonary aspergillosis.
- To assess the effectiveness of surgical intervention as a primary treatment for pulmonary aspergilloma.
Main Methods:
- A retrospective analysis of 84 patients undergoing surgery for pulmonary aspergillosis between 1983 and 1995.
- Data collected included patient demographics, pre-operative diagnoses (e.g., aspergilloma, tuberculosis), diagnostic methods (chest X-ray), and surgical procedures (pulmonary resection, cavernostomy).
Main Results:
- Pulmonary resection was performed in 71 patients; cavernostomy in 12.
- The post-operative mortality rate was 9.5%, with common complications including bleeding, empyema, bronchial fistula, and wound infection.
- Complications were more frequent in patients with larger cavities near the chest wall.
Conclusions:
- Surgical intervention remains the primary effective therapy for most cases of pulmonary aspergilloma.
- Asymptomatic patients without pleural or chest wall involvement have a lower surgical risk.
- Cavernostomy may be the only viable surgical option in select cases.