0
Original Research: Chest Infections |

Lung Resection in Hematologic Patients With Pulmonary Invasive Fungal DiseaseLung Surgery for Invasive Fungal Disease

Christian A. Nebiker, MD; Didier Lardinois, MD; Lilian Junker, MD; Franco Gambazzi, MD; Peter Matt, MD; James M. Habicht, MD; Joerg Halter, MD; Dominik Heim, MD; Martin Stern, MD; Andreas S. Buser, MD; Jakob Passweg, MD; Daiana Stolz, MD, FCCP; Ursula M. Flückiger, MD; Maja Weisser, MD; Manuel Battegay, MD; Lukas Bubendorf, MD; Alois Gratwohl, MD; Michael Tamm, MD, FCCP
Author and Funding Information

From the Division of Thoracic Surgery (Drs Nebiker, Lardinois, and Gambazzi), Division of Pneumology (Drs Junker, Stolz, and Tamm), Division of Cardiac Surgery (Drs Matt and Habicht), Division of Hematology (Drs Halter, Heim, Stern, Buser, Passweg, and Gratwohl), Division of Infectious Diseases and Hospital Epidemiology (Drs Flückiger, Weisser, and Battegay), and Department of Pathology (Dr Bubendorf), University Hospital Basel, Basel, Switzerland.

Correspondence to: Christian A. Nebiker, MD, Division of Thoracic Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; e-mail: nebikerc@uhbs.ch


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(4):988-995. doi:10.1378/chest.11-1964
Text Size: A A A
Published online

Background:  Pulmonary invasive fungal disease is a frequent complication in patients with hematologic malignancies. Surgical resection in addition to antifungal therapy is an option for selected cases but often feared because of immunosuppression.

Methods:  We analyzed the outcome of 71 patients undergoing lung resection for pulmonary invasive fungal disease. Most patients had leukemia, 44 underwent high-dose chemotherapy, and 18 underwent stem cell transplantation.

Results:  On the day of surgery, 44 patients were neutropenic, and 41 had a platelet count < 50 × 109/L. Forty-five nonanatomic (atypical) resections and 26 lobectomies were performed. Fungal infection was histologically proven in 53 patients. Reoperation was needed in four patients (bronchial stump dehiscence, persistent air leak, chylothorax, and seroma). Minor complications at the site of surgery occurred in 14 patients. In only two, there was an uncontrolled disseminated fungal infection. Overall, mortality at 30 days was 7% (five of 71). Long-term survival was mainly influenced by the underlying hematologic disease.

Conclusions:  Lung resection is a therapeutic option for hematologic patients with pulmonary fungal infection. Despite immunosuppression, the perioperative morbidity and mortality is acceptable, and, therefore, the prognosis is not determined by the surgical intervention.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543