Surgical treatment of pulmonary aspergilloma

Ref ID: 18427

Author:

Jelmer Oor , Jos Bekaert, Johannes Daniels, Pieter Postmus,
Koen Hartemink, Marinus Paul, Wolter Oosterhuis.

Author address:

Pulmonary Diseases, VU
University Medical Center, Amsterdam, Netherlands; Surgery, VU University
Medical Center, Amsterdam, Netherlands

Full conference title:

European Respiratory Congress

Abstract:

Pulmonary aspergilloma or mycetoma is a ball-shaped fungal infection, which is
mostly encountered in pre-existing pulmonary cavities. Local inflammation, high
vascularity and pre-existing lung damage can complicate surgical resection. We
aimed to describe our patient population, the employed surgical techniques and
the postoperative follow-up.
We performed a retrospective analysis of all patients who underwent surgical
resection for an aspergilloma between January 2003 and September 2010. Using
the patient charts, we examined the clinical data as well as the type of surgical
technique that was used. SPSS 17.0 (SPSS INC, Chicago, IL) was used for data
analysis.
Twenty-three patients underwent surgical resection for pulmonary aspergilloma.
Seventeen (74%) were men, the mean age was 53 years and 43% of the patients
presented with hemoptysis. Underlying diseases included hematological malignancies
(n=8), (a history of) tuberculosis (n=3) and M. Bechterew (n=2). The
most frequently employed surgical techniques consisted of wedge resection (n=8),
lobectomy (n=7), pneumonectomy (n= 2) and segmentectomy (n=2). The duration
of the hospitalization after the first surgical resection varied from 5 to 141 days
(median 17, IQR, 9-33,25). The median time required for the first surgical resection
was 3:34 hours (IQR, 2:34-5:07). Six patients (26%) underwent a rethoracotomy.
Four patients died within 6 months after surgery.
Comorbidities were common, the duration of the surgical resections and hospital
admissions was long and rethoracotomy was required in 26% of the cases. This
illustrates the technical challenges for the surgeon and necessitates treatment in
expert centers.

Abstract Number: 4699

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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