Aspergilloma: A series of 89 surgical cases

Background. Surgery for pleuropulmonary aspergilloma is reputed to be risky . We reviewed our results, focusing attention on the postoperative complica tions. Methods. During a 20-year period, 87 patients were operated on for pulmonar y (86) or pleural (3) aspergillomas, Seventy-two percent of patients were c omplaining of hemoptysis. Eighty-nine resections were performed because the re were two bilateral cases. Seventy percent of aspergillomas had developed in cavitation sequelaes from tuberculosis disease. Thirty-four patients ha d severe respiratory insufficiency that allowed us to perform only lobectom y (18), segmentectomy (2), or cavernostomy (14). Results. Thirty-seven lobectomies (five with associated segmentectomies), t wo bilobectomies, 21 segmentectomies, 10 pneumonectomies, and 17 cavernosto mies were performed. Total blood loss exceeded 1,500 mL in 14 cases, and 71 % of patients required blood transfusion. There were five postoperative dea ths (5.7%), related to respiratory failure (2), infectious complication (1) , pulmonary embolus (1), and cardiorythmic disorder (1), incomplete reexpan sions were frequently seen in patients undergoing lobectomies or segmentect omies. No death or major complications occurred in asymptomatic patients, D uring follow-up, none of the patients had recurrent hemoptysis, Conclusions, Surgical resection of aspergilloma is effective in preventing recurrence of hemoptysis. it has low risk in asymptomatic patients and in t he absence of underlying pulmonary disease, incomplete reexpansion is frequ ent after lobectomy and segmentectomy, especially when there is underlying lung disease. Cavernostomy is an effective treatment in high-risk patients. Long-term prognosis is mainly dependent on the general condition of patien ts.