[Pulmonary aspergilloma surgery: a mono-institutional experience].

INTRODUCTION

Pulmonary aspergiloma or mycetoma is a saprophytic colonization of a preexisting cavity by aspergilloma. Surgical resection is the only effective long-term treatment, but remains controversial because of the high rate of complications in the perioperative and postoperative time.

OBJECTIVES

Analysis of the experience of a Cardiothoracic Surgery Center for the treatment of pulmonary aspergilloma and evaluation of the prognostic factors after surgery.

MATERIAL AND METHODS

Retrospective analysis including all the patients with a diagnosis of pulmonary aspergilloma submitted to surgery for a 10 years period, in a single institution (June 2001-June 2011).

RESULTS

The study included 22 patients (18 men) with a mean age of 51.0 + 17.4 years. Of them, 46% were smokers, 41% were alcoholic and 50% had a previous history of tuberculosis. Most of the patients had a complex aspergilloma (73%) and 17% a simple aspergilloma. The most common presentation was hemoptysis (50%). The common surgical procedure performed was atypical lung resection in 55%, lobectomy in 27% and pneumectomy in 9%. Two patients were submitted to thoracoplasty. There was one operative death (5%). Postoperative complications occurred in 36% and the most frequent were pneumothorax (18%) and empyema (18%). The mean follow-up period was 52 months (3 - 116) and the 5 years mortality rate of 35%. Of them, 4 patients died because of non-related causes and 3 were immunosuppressed patients. The mortality was 40% in the group of complex aspergilloma and 33% in the group of complex aspergilloma.

DISCUSSION

The most common surgical procedure performed was atypical lung resection. The postoperative complications rate was similar to previous studies.

CONCLUSION

Surgical resection of aspergilloma presents a low morbidity and mortality. Therefore, for patients with lung function preserved, it is the preferred treatment.