Results Of Surgery Of Chronic Pulmonary Aspergillosis – Our Centre'S Experience.

Results Of Surgery Of Chronic Pulmonary Aspergillosis – Our Centre’S Experience.

Rev Port Cir Cardiotorac Vasc. 2020 Oct-Dec;27(4):268

Authors: Costa R, Coelho D, Maciel J, Fernandes P, Pinho P

Introduction Aspergilloses refers to a spectrum of disease caused by Aspergillus species that includes simple aspergiloma, chronic cavitary pulmonary aspergillosis (CCPA) and subacute invasive aspergillosis (SAIA) (1;3). Surgical results of CCPA or SAIA are worse when compared with those for simple aspergilloma, and the surgical indications remain somewhat unclear. These patients can be challenging due to ongoing inflammatory process and the risk for postoperative complication. (1,2;3). Objectives We retrospectively reviewed our surgical results between August 2010 and August 2020. Results Twenty-five patients underwent surgery for pulmonary aspergillosis at Department of Cardiothoracic Surgery of University Hospital Center of São João: 12 patients (48.0%) with aspergilloma, 10 (40.0%) with chronic cavitary pulmonary aspergillosis and 3 (12.0%) with sub-acute invasive aspergillosis. We excluded the pediatric patients. Seventeen patients were males with a median age of 48 years-old (range 19-69). Five patients had COPD, 7 patients were immunocompromised, 10 patients had bronchiectasis on CT scan and 12 patients had a previous history of tuberculosis. Hemoptysis was the most frequently symptom (44%) and was the main reason of refer for surgery. Nineteen patients were submitted to lobectomy (76%), 5 patients were submitted to wedge resections (20%) and one patient was submitted to a left pneumectomy (4%). More than half of the patients (52% n=13) had mainly the left superior lobe affected by aspergillosis follow by superior right lobe and inferior left lobe (24% each). Median time at hospital was 8 days (4-98) and medium time of drainage was 7 days (1-47). Prolonged pulmonary air leak was the most frequently (20% of patients) complication follow by non-nosocomial respiratory infection (12%), chronic pain (8%) and hemothorax (4%). At the end of the follow-up 23 patients were alive (92%). Results were considered statistically significant if p < 0,05. In our study there was no statistically significant differences in hospital length of stay, length of drainage and rate of complications according to subtype of aspergilloses (aspergiloma; CCPA and SAIA). Conclusions There were no relapses of aspergillosis on the first year after surgery on patients who kept outpatient following.

PMID: 33280300 [PubMed – as supplied by publisher]

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