Surgical Treatment Outcomes of Pulmonary Aspergilloma in Central Chest Institute of Thailand

Abstract

Background: Pulmonary aspergilloma is a disease from colonization of Aspergillus fumigatus in the lung cavity with a difficult therapeutic problem. Surgery is an aggressive way to treat. Objective: To analyze the early surgical treatment outcomes of pulmonary aspergilloma. Materials and Methods: Fifty-nine patients that underwent surgery for pulmonary aspergilloma in Central Chest Institute of Thailand between January 2015 and August 2019 were reviewed. Patient characteristics and perioperative and operative outcomes were analyzed and reported. Results: The most frequent symptoms were recurrent hemoptysis (54.2%). The main procedure was lobectomy. The most location of aspergilloma were the right upper lobe (38.98%) and left upper lobe (30.50%). The intraoperative blood loss ranged from 140 to 600 mL with a median of 350 mL. The mean hospital stay was 15 days. The mean duration of pleural drainage was 12 days. The mean follow up was 748 days. No intraoperative death. The mortality rate was 3.4%. The recurrence rate was 1.70%, and the overall complication rate was 52.54%. The most frequent early complications were prolonged air leaks (16.90%), treated by conservative treatment. Most late complications were recurrent hemoptysis (8.50%), and the mean occurrence time was 484 days. The reoperation treatment rate for complications was 25.8%. Conclusion: Surgical treatment for aspergilloma can control symptoms, prevent recurrent hemoptysis, and save life. With the significant risk of postoperative complications, surgery should be offered primarily to patients with intense symptoms or medical failure. Keywords: Pulmonary Aspergilloma; Surgical treatment; Pulmonary resection