Treatment of pulmonary aspergilloma in Srinagarind Hospital.

BACKGROUND

Controversy still exists concerning the optimum management of aspergilloma.

OBJECTIVE

To evaluate clinical data of patients, the indications for surgery, postoperative complications and results of all treatments of pulmonary aspergillosis compare with data from review literature, to find out the optimum management.

MATERIAL AND METHOD

The authors retrospectively reviewed medical records of 45 patients at Srinagarind Hospital who had pulmonary aspergilloma between 1993 and 2008. General data, associated diseases, symptoms, organs involvement, treatments, surgical indications, procedures and complications, and outcome were collected for analysis.

RESULTS

Associated diseases were found in 33 patients (73.3%). Tuberculosis was the most common underlying causes. Hemoptysis, the most frequent symptom, occurred in 29 patients (64.4%0). If 40 patients, they only had lung lesion although 5 patients had multiple organ-involvement. Surgery was performed in 24 patients (53.3%). Hemoptysis was the most common indication and lobectomy was the most frequent procedure. Postoperative complications occurred in 5 cases (20.80%) and mortality rate after surgery = 4.2%. Embolization was done on 4 patients; none of them re-bled. Clinical outcome improved in 36 cases (80%), did not improved in 6 patients (13.3%), and resulted in 3 patients' death (6. 7%).

CONCLUSION

The most common indication for surgery was hemoptysis. Recurrence of hemoptysis was found in all patients who received selective bronchial artery embolization. Surgical resection is the treatment of choice with acceptable postoperative complications and mortality rate.