Nakatsukasa Takaaki, Kondou Masamichi, Shiraishi Toshio, Fukushima Ayako, Tanoue Yukinori, To Kazuo, Oka Tadayuki
Department of Sugery,Ureshino Medical Hospital, Ureshino, Japan.
Kyobu Geka. 2020 Feb;73(2):83-86.
The number of cases requiring surgical resection for pulmonary aspergillosis has increased in recent years.
From April 2008 to March 2019, 10 patients underwent pulmonary resection for chronic pulmonary aspergillosis(CPA) in our hospital.
Five patients were diagnosed with simple pulmonary aspergilloma (SPA) and 5 were diagnosed with chronic progressive pulmonary aspergillosis( CPPA). The median age was 73 years, and 8 patients were men. A history of tuberculosis was present in 2 cases, diabetes was present in 3 cases, and prednisolone( PSL) administration was performed in 3 cases. The operative procedures included 1 pneumonectomy, 4 lobectomies, 1 segmentectomy, and 4 wedge resections. The median surgery time was 220.5 minutes, and the median blood loss was 301 ml, requiring perioperative transfusion in 2 cases. Postoperative pneumonia was observed in 2 cases. The median postoperative observation period was 11.5 months, and 6 out of 8 patients did not show postoperative recurrences.
Although patients with pulmonary aspergillosis have a high rate of underlying disease and it is necessary to pay attention to postoperative complications, it has been shown that surgery can be performed safely on these patients by selecting appropriate cases and surgical procedures.
近年来，因肺曲霉病需要进行手术切除的病例数量有所增加。
2008年4月至2019年3月，我院有10例患者因慢性肺曲霉病（CPA）接受了肺切除术。
5例患者被诊断为单纯肺曲霉球（SPA），5例被诊断为慢性进行性肺曲霉病（CPPA）。中位年龄为73岁，8例为男性。2例有结核病史，3例有糖尿病史，3例曾使用泼尼松龙（PSL）。手术方式包括1例全肺切除术、4例肺叶切除术、1例肺段切除术和4例楔形切除术。中位手术时间为220.5分钟，中位失血量为301毫升，2例患者围手术期需要输血。2例患者术后出现肺炎。术后中位观察期为11.5个月，8例患者中有6例术后未复发。
尽管肺曲霉病患者基础疾病发生率较高，且有必要关注术后并发症，但已表明通过选择合适的病例和手术方式，可对这些患者安全地进行手术。
