Lejay Anne, Falcoz Pierre-Emmanuel, Santelmo Nicola, Helms Olivier, Kochetkova Evgenia, Jeung My, Kessler Romain, Massard Gilbert
Department of Thoracic Surgery, NHC, Strasbourg, France.
Interact Cardiovasc Thorac Surg. 2011 Oct;13(4):392-5. doi: 10.1510/icvts.2011.265553. Epub 2011 Jul 5.
Surgery of aspergilloma has been renowned to be technically challenging and has a high complication rate. We have already demonstrated an improved outcome as a result of a reduction in complex cases related to history of tuberculosis. In this paper we will evaluate whether this time trend has continued during recent years. Initial presentation and postoperative outcome of 33 patients who underwent surgical treatment between 1998 and 2009 were reviewed and compared with two previous reports (group 1: 55 patients from 1974 to 1991; group 2: 12 patients from 1992 to 1997). Underlying disease was tuberculosis in 15% of patients (57% in group 1, 17% in group 2), and 12% of patients had complex aspergillomas (80% in group 1, 41% in group 2). Postoperatively, there was no mortality (5% in group 1, 0% in group 2). Morbidity decreased progressively in terms of bleeding (44% in group 1, 9% in group 2, and 6% in recently, accrued patients), of pleural space problems (47%, 18% and 12%, respectively), and of prolonged hospital stay (32%, 8% and 6%, respectively). With a decreased postoperative complications rate after resection, contemporary surgery of aspergilloma is safe and offers satisfactory early and long-term results.
曲霉菌瘤手术一直以技术难度大、并发症发生率高而闻名。我们已经证明，由于与结核病病史相关的复杂病例减少，手术效果有所改善。在本文中，我们将评估近年来这种时间趋势是否持续。回顾了1998年至2009年间接受手术治疗的33例患者的初始表现和术后结果，并与之前的两份报告进行了比较（第一组：1974年至1991年的55例患者；第二组：1992年至1997年的12例患者）。15%的患者潜在疾病为结核病（第一组为57%，第二组为17%），12%的患者患有复杂曲霉菌瘤（第一组为80%，第二组为41%）。术后无死亡病例（第一组为5%，第二组为0%）。在出血方面（第一组为44%，第二组为9%，最近累积患者为6%）、胸腔问题方面（分别为47%、18%和12%）以及住院时间延长方面（分别为32%、8%和6%），发病率逐渐降低。随着切除术后并发症发生率的降低，当代曲霉菌瘤手术是安全的，并能提供令人满意的早期和长期结果。
