Abstract
BackgroundSurgical resection is considered to be the most effective treatment for localized pulmonary mycotic infections. However it is also a particularly challenging procedure because it is associated with considerable mortality and morbidity. Furthermore, hematopoietic disorders usually cause immunosuppression, anemia, and coagulopathy, which are definite risk factors for surgery. The purpose of this study is to evaluate the surgical outcomes of pulmonary mycotic infections in hematopoietic disorder patients.MethodsBetween 2011 and 2013, 23 patients underwent surgical treatment for pulmonary mycotic infections at a single institution. The patients were divided into two groups; Group A (hematopoietic disorder patients, n = 9) and Group B (n = 14). We retrospectively reviewed medical and radiologic data.ResultsThe complex type was more frequent in group A (66.6 %) than in group B (35.7 %). Postoperatively, there was no mortality. However, morbidity was 22.2 % (2 incomplete expansion) in group A, and 35.6 % (1 prolonged air leak, 3 bleeding, 1 Bronchopleural fistula) in group B. The difference in morbidity between the groups did not show any statistical significance (p = 0.657) as well as duration of chest tube drainage, and postoperative hospital stay. The hematopoietic disorder patients did not impose a risk factor for morbidity and mortality.ConclusionsAlthough hematopoietic disorder patients have many surgical risk factors, the surgical treatment of pulmonary mycotic infections produces very acceptable outcomes in selected cases.
Highlights
Surgical resection is considered to be the most effective treatment for localized pulmonary mycotic infections
The immunosuppression of these patients could be caused by the underlying disease itself, but in many cases it has intensified after chemotherapy treatment or hematopoietic stem cell transplantation (HSCT)
In order to evaluate the surgical outcomes of hematopoietic disorder patients, the patients were divided into two groups; Group A and Group B, and the characteristics and surgical outcomes of the two groups were compared
Summary
Surgical resection is considered to be the most effective treatment for localized pulmonary mycotic infections. Hematopoietic disorder is a common designation for hematopoiesis-related diseases such as aplastic anemia, myelodysplastic syndrome, and leukemia [1]. Because they often suffer from immunosuppression, anemia and/or coagulopathy, patients with this disorder are considered to be high-risk factor for operation [2]. The immunosuppression of these patients could be caused by the underlying disease itself, but in many cases it has intensified after chemotherapy treatment or hematopoietic stem cell transplantation (HSCT). Fungal disease occurring in this type of Various fungi can cause pulmonary mycotic infections, of which Aspergillus infection is the most frequent [7].
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