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Cardiothoracic Surgery |

Surgical Approach of Pulmonary Aspergilloma

Alexandru-Mihail Botianu*, MD; Petre Vlah-Horea Botianu, MD
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University of Medicine and Pharmacy, Tirgu-Mures, Romania


Chest. 2012;142(4_MeetingAbstracts):61A. doi:10.1378/chest.1389998
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Abstract

SESSION TYPE: Thoracic Surgery Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: The objective of this paper is to evaluate the results of surgery for pulmonary aspergilloma.

METHODS: We performed a retrospective study on 35 patients operated in our unit between 01.01.1985-01.01.2011 for pulmonary aspergilloma. All the patients were referred for surgery after failure of the medical treatment and received postoperative treatment with specific antifungal drugs (amphotericine, voriconasole). Most patients (32 out of 35) presented a history of tuberculosis (TB) with the aspergilloma developing on TB lesions. Surgery consisted in lung resection in 28 cases (lobectomy - 5 cases, non-anatomic - 23, with 6 cases associating an applatisation-plication of the cavity) and thoracomioplasty in 7 cases. The following main parameters were followed: mortality, morbidity, reoperations, hospitalisation - intensive care unit (ICU) and overall, status at one year after surgery.

RESULTS: Overall mortality was 5,7% (2 patients). We encountered 3 residual suppurated cavities requiring a major reoperation (open-window or thoracoplasty). ICU stay after surgery ranged between 1 and 6 days, with an average of 2 days. Postoperative hospitalisation ranged between 10 and 87 days, with an average of 27 days. At one-year follow-up (clinical, sputum bacteriology, chest X-ray +/- CT scan) we have encountered no recurrence, with two deaths not related to the thoracic problems.

CONCLUSIONS: Surgery remains an option for patients with aspergilloma not responding to medical treatment. In selected cases, both lung resection and thoracomioplasty may give good results.

CLINICAL IMPLICATIONS: Surgical treatment for aspergilloma remains a challenge due to the technical difficulties and the poor biological status of the patients.

DISCLOSURE: The following authors have nothing to disclose: Alexandru-Mihail Botianu, Petre Vlah-Horea Botianu

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University of Medicine and Pharmacy, Tirgu-Mures, Romania

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