Ono N, Sato K, Yokomise H, Tamura K
Department of Thoracic Surgery, Japanese Red Cross Society Wakayama Medical Center, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Jan;48(1):56-9. doi: 10.1007/BF03218085.
We reviewed the outcome of the patients with aspergilloma who were treated surgically.
Between July 1991 and October 1996, 11 patients with pulmonary aspergilloma underwent surgery. One underwent sequential bilateral tboracotomy and two underwent re-operation. The total number of operations was 14. Surgical procedures consisted of 5 cavernostomies with muscle transposition, 3 cavernostomies with muscle transposition and thoracoplasty, 1 lobectomy 1 pneumonectomy, 1 segmentectomy and 3 partial resections.
Morbidity and mortality rates were 28.6% and 7.1%, respectively Two patients who underwent cavernostomy and muscle transposition experienced a relapse of aspergilloma 19 and 29 months after the operation, respectively, but both successfully underwent re-operation, including cavernostomy. Both are free of symptoms 28 and 30 months after re-operation, respectively. All survivors except for one who died of multiple organ failure remain free of symptoms 14 to 60 months after the most recent operation.
Our experience was not a controlled trial and two relapsed cases had undergone cavernostomy, our series may suggest that single-stage cavernostomy with muscle transposition is a viable surgical option for patients with pulmonary aspergilloma.
我们回顾了接受手术治疗的曲菌球患者的治疗结果。
1991年7月至1996年10月期间，11例肺曲菌球患者接受了手术。1例患者接受了序贯双侧开胸手术，2例患者接受了再次手术。手术总数为14例。手术方式包括5例带肌肉转移的空洞造口术、3例带肌肉转移和胸廓成形术的空洞造口术、1例肺叶切除术、1例全肺切除术、1例肺段切除术和3例部分切除术。
发病率和死亡率分别为28.6%和7.1%。2例接受空洞造口术和肌肉转移的患者分别在术后19个月和29个月出现曲菌球复发，但均成功接受了再次手术，包括空洞造口术。再次手术后分别在28个月和30个月时均无症状。除1例死于多器官功能衰竭外，所有幸存者在最近一次手术后14至60个月均无症状。
我们的经验并非对照试验，且有2例复发病例接受了空洞造口术，我们的系列研究可能提示，对于肺曲菌球患者，单阶段带肌肉转移的空洞造口术是一种可行的手术选择。
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