Cavernoplasty for pulmonary aspergillosis associated with restrictive ventilatory impairment

Abstract

Nine patients were diagnosed as suffering from localized pulmonary aspergillosis associated with restrictive ventilatory impairment. Eight cases reportedly received a combination of thoracoplasty and cavernoplasty, while one case received only cavernoplasty. The following postoperative courses were observed in these nine patients: of the eight patients having combined thoracoplasty and cavernoplasty, seven patients were cured as the result of successful cavity closures. Cavernotomy was required for the remaining patient whose cavity failed to close. An attempt was made to close the cavity of the one patient reported to have only cavernoplasty, but the cavity failed to close on the first attempt. The cavity was successfully closed in a later attempt using thoracoplasty. Although the application of thoracoplasty and cavernoplasty is useful and safe to the treatment of patients being unable to undergo resection and/or having pulmonary dysfunction, it is very important to reduce the number of ribs being resected because pulmonary function may be more worsened after operation. A combination of extraperiosteal detachment and cavernoplasty seems to be a useful alternative. A lower limitation of the postoperative ventilation function, evaluated as a ratio of FEV1.0/VCpr is thought to be 20%.