Abstract
Objective: This retrospective study was designed to examine the acute and long-term outcomes
after surgical treatment of patients with pulmonary aspergillomas. Patients and Methods: From 1992 to 2006, 24 patients (21 men, mean age 58.4 years) with pulmonary aspergillomas
underwent pulmonary resection. Operative indications were massive or repetitive hemoptysis
in 6 patients, medically unmanageable localized infection in 14 patients, and undetermined
mass in 4 patients. Eighteen patients (75.0 %) had background pulmonary diseases and
four patients (16.7 %) were mildly immunocompromised. Eight patients had simple aspergillomas,
while sixteen patients had complex aspergillomas. Two patients with pleural empyema
had their pleural spaces sterilized before pulmonary resections. Fungus balls and
pulmonary cavities along with the surrounding lung were removed in all patients. Results: Surgical procedures consisted of 13 lobectomies, 5 pneumonectomies including one
completion penumonectomy, 2 segmentectomies and 4 wedge resections. Postoperative
complication occurred in 10 patients (41.6 %) and one patient died from aortic bleeding
due to postoperative empyema. Other major complications were prolonged air leaks,
bleeding, and chylothorax. In the follow-up period, all but one patient were free
from aspergillosis. Hemoptysis was not seen in any patient. Overall survival rates
at 2, 5, and 10 years were 86.6 %, 79.4 % and 79.4 %, respectively. Disease-free survival
rates from aspergillosis were 86.6 %, 72.6 % and 72.6 % at 2, 5, and 10 years, respectively.
Conclusion: Pulmonary resection for aspergilloma showed favorable acute and long-term outcomes
when surgical treatment was applied in selected patients.
Key words
thoracic surgery - aspergilloma - empyema
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MD Kenichi Okubo
Thoracic Surgery
Kyoto University Hospital
54 Kawahara-cho, Shogoin
Sakyo-ku
606-8507 Kyoto
Japan
Telefon: + 8 17 57 51 49 75
Fax: + 8 17 57 51 49 74
eMail: okubok@kuhp.kyoto-u.ac.jp