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Acta medica Lituanica

ISSN 1392-0138
ISSN 2029-4174 (online)

2008 m. Nr. 2

Surgical treatment of pulmonary aspergilloma
Vladislavas VENCEVIČIUS, Saulius CICĖNAS


Background. Evaluating the clinical findings and results of surgical treatment of pulmonary aspergilloma, the authors describe their experience in surgical treatment of pulmonary aspergilloma and postoperative complications rates.

Materials and methods. 54 patients (pts) with pulmonary aspergilloma were operated from 1979 to 2006 in the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University. Most common clinical symptom of pulmonary aspergilloma was haemoptysis, which occurred in 47 pts (87%). Tuberculosis was the most common pre-existing disease in 35 pts (64.8%).

Results. Conventional chest X-rays showed typical ‘air-crescent’ sign in 41 pts (75.9%). 55 operations were performed for 54 pts (including one bilateral resection): lung resections for 50 pts (92.5%), segmentectomy in 14 pts (25.9%), lobectomy in 26 pts (48.1%), pneumonectomy in 10 pts (18.5%), pleurectomy in 2 pts (3.7%) and cavernostomy in 3 pts (5.5%). Postoperative complications occurred in 15 pts (27.7%): empyema in 5 pts (33.3%), massive bleeding in 3 pts (20%), bronchopleural fistula in 2 pts (13.3%), wound infection in 2 pts (13.3%), and residual pleural space in 3 pts (20.0%). Conservative treatment of the complications was effective.

Conclusions. 1. Surgery for aspergillomas is mandatory in cases of appearance of clinical manifestation of the disease and disease progression: bleeding from lungs; tumour size enlargement during conservative treatment and adequate pulmonary function. 2. The main surgical operation in case of aspergilloma is lung resection performed in 50 patients (92.5%) of this group. Postoperative complications were observed in 15 patients (27.7%). All patients recovered.

Keywords: aspergilloma of the lung, tuberculosis of the lung, haemoptysis, thoracic surgery

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