The fate of aspergilloma patients after surgical treatment-experience from 22 cases

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Pihlajamaa , K , Anttila , V-J , Räsänen , J V , Kauppi , J T & Hodgson , U 2019 , ' The fate of aspergilloma patients after surgical treatment-experience from 22 cases ' , Journal of thoracic disease , vol. 11 , no. 10 , pp. 4298-4307 .

Title: The fate of aspergilloma patients after surgical treatment-experience from 22 cases
Author: Pihlajamaa, Katriina; Anttila, Veli-Jukka; Räsänen, Jari V.; Kauppi, Juha T.; Hodgson, Ulla
Contributor organization: HUS Heart and Lung Center
HUS Inflammation Center
University of Helsinki
Infektiosairauksien yksikkö
III kirurgian klinikka
Date: 2019-10
Language: eng
Number of pages: 10
Belongs to series: Journal of thoracic disease
ISSN: 2072-1439
Abstract: Background: Patients with pulmonary aspergillomas occasionally undergo surgery but it is somewhat unclear who of these patients benefit from surgical treatment. Methods: We retrospectively evaluated all 22 patients that underwent surgery in Helsinki University Central Hospital between 2004 and 2017. We assessed their clinical backgrounds, anti-fungal medication, indication for surgery, complications, recurrent infections and survival. Results: Of the 22 patients, 14 male and 8 female, mean age 56, an underlying pulmonary disease was present in 20. On immunosuppressive medication were 8 (36%). Most received anti-fungal medication preoperatively (n=12) and/or postoperatively (n=17), 3 patients did not receive anti-fungal medication. Length of the medication periods were diverse. Main indication for surgery was haemoptysis. One in-hospital-death occurred, and other complications included prolonged air-leak, postoperative pneumonia, pneumothorax and pneumomediastinum. No Aspergillus empyema or pleurites occurred. Five-year survival was 54%. One in-hospital-death and one other death were the result of Aspergillus disease, other deaths were unrelated to Aspergillus. Recurrent disease occurred in four cases. Three of these patients were asthma patients with allergic bronchopulmonary aspergillosis (ABPA). Conclusions: Overall results of surgery in this cohort were good and number of complications was low. Therapy with antifungals was diverse. Surgical treatment of aspergilloma can be life-saving for patients suffering of haemoptysis, and patients with restricted disease and well-preserved pulmonary capacity may benefit from surgery. Careful patient selection is crucial.
Subject: Pulmonary aspergillosis
thoracic surgery
antifungal agents
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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