BRONCHOPULMONARY ASPERGILLOMA - A REAPPRAISAL

Background. Classically, most complications observed after operations for aspergilloma occurred in patients with sequelae of tuberculosis. B ecause the incidence of tuberculosis has declined over the past two de cades, aspergilloma is expected to develop with increasing frequency i n patients without previous tuberculosis. Therefore, our hypothesis wa s that operative outcome should have improved during the most recent y ears in comparison with our previous experience.Methods. Operative out come of 12 recently accrued patients was evaluated and compared with a historic control group of 55 patients, previously reported by the sam e center. Results. As expected, only 17% of patients of the present se ries had a history of tuberculosis, compared with 57% in the former se ries. Postoperatively, there was no mortality. Major morbidity has dec reased, although this difference is not statistically significant: ble eding decreased from 44% to 9% of patients; space problems decreased f rom 47% to 18%; and prolonged hospital stay (>30 days) decreased from 32% to 9%. Conclusions. Our results support a trend toward improved po stoperative outcome of operations for aspergilloma owing to a decrease d incidence of aspergilloma growing in tuberculous cavitations. (C) 19 98 by The Society of Thoracic Surgeons.