Park Chang Kwon, Jheon Sanghoon
Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, South Korea.
Eur J Cardiothorac Surg. 2002 May;21(5):918-23. doi: 10.1016/s1010-7940(02)00104-5.
The purpose of this retrospective study is to analyze the results of the surgical treatment for pulmonary aspergilloma and to confirm that aggressive surgical resection can provide effective outcome for these patients.
From 1987 to 2000, 110 patients underwent thoracotomy for treatment of pulmonary aspergilloma in two hospitals. The most common indication for operation was hemoptysis (82%). Underlying diseases were tuberculosis (89%), bronchiectasis (5%), carcinoma (3%), lung tumor (1%) and none (2%). The procedures were lobectomy (74%), segmentectomy (12%), wedge resection (9%), pneumonectomy (4%) and cavernoplasty in two patients. Twenty-nine patients (26%) had severe underlying intrathoracic pathologies.
Postoperative complications occurred in 23.6% of the patients including: empyema (n=13), bleeding (n=6), respiratory insufficiency (n=2), wound infection (n=4) and bronchopleural fistula (n=1). There was one hospital death due to panperitonitis after gastric ulcer perforation.
We recommend early surgical resection of symptomatic aspergilloma and even asymptomatic cases with reasonable complication.
本回顾性研究旨在分析肺曲菌球手术治疗的结果，并证实积极的手术切除可为这些患者带来有效的治疗效果。
1987年至2000年，两家医院的110例患者接受了开胸手术治疗肺曲菌球。最常见的手术指征是咯血（82%）。基础疾病为肺结核（89%）、支气管扩张（5%）、癌症（3%）、肺部肿瘤（1%）和无基础疾病（2%）。手术方式为肺叶切除术（74%）、肺段切除术（12%）、楔形切除术（9%）、全肺切除术（4%），另有2例患者行空洞成形术。29例患者（26%）存在严重的胸腔内基础病变。
23.6%的患者发生术后并发症，包括：脓胸（n = 13）、出血（n = 6）、呼吸功能不全（n = 2）、伤口感染（n = 4）和支气管胸膜瘘（n = 1）。1例患者因胃溃疡穿孔后发生弥漫性腹膜炎死亡。
我们建议对有症状的曲菌球尽早进行手术切除，对于无并发症的无症状病例也应考虑手术。
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