Abstract
BackgroundIn high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed. This study aimed to evaluate this surgery compared two compressing materials.MethodsA total of 63 in high-risk patients who suffered from hemoptysis due to complex pulmonary aspergilloma and underwent cavernostomy and thoracoplasty surgery from November 2011 to September 2018 at Pham Ngoc Thach hospital were evaluated prospectively studied. Patients were allocated to two groups: the table tennis ball group and tissue expander group. We evaluated at the time of before operation, 6 months and 24 months after operation.ResultsTuberculosis was the most common comorbidity diseases in both groups. Upper lobe occupied almost in location. Hemoptysis symptoms plunged from time to time. Statistically significant Karnofsky score was observed in both groups. Postoperative pulmonary functions (FVC and FEV1) have remained in both groups at all time points. The remarkable results were no deaths related to surgery and low complications both short and long-term. There was no statistical significance between two groups in operative time, blood loss during operation, ICU length-stay time. Four patients died because of co-morbidity in 24 months follow-up.ConclusionCavernostomy and thoracoplasty was safe and effective surgery for the treatment of complex pulmonary aspergilloma with hemoptysis in high-risk patients. No mortality related to surgery and low complications were recorded. The was no inferiority when compared two compressing materials .
Highlights
In high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed
This study presented the details of high-risk patients who underwent cavernostomy and thoracoplasty using compressing material for complex pulmonary aspergilloma with hemoptysis
We evaluated 63 high-risk patients who suffered from hemoptysis due to complex pulmonary aspergilloma and underwent cavernostomy and thoracoplasty from November 2011 to September 2018
Summary
In high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed. In low-risk patients, the first choice was pulmonary resection [5], which considered as an appropriate therapy for simple pulmonary aspergilloma with low morbidity and mortality [6,7,8]. It was not the preferred therapy in high-risk patients such as complex pulmonary aspergilloma which has a thick wall of aspergilloma or underlying pleural and parenchymal sequelae. In these patients especially when hemoptysis occurs, immediate treatment is critical because of life-threatening.
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