@Article{Kasprzyk2017,
journal="Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery",
issn="1731-5530",
volume="14",
number="2",
year="2017",
title="Surgical treatment for pulmonary aspergilloma – early and long-term results",
abstract=" Introduction : Pulmonary aspergilloma is a difficult therapeutic problem due to the low effectiveness of conservative treatment and high surgical morbidity.   Aim : To analyze the early and late results of surgical treatment for pulmonary aspergilloma.   Material and methods:   From 2005 to 2015, 49 patients were treated surgically for pulmonary aspergilloma. Symptoms occurred in 85.7% of cases, including recurrent hemoptysis in 53%. A history of immunosuppressive therapy or chemotherapy was noted in 24.5% of patients. Complex aspergilloma was diagnosed in 79.6% of cases. Immunological test results were positive in 10.2%, and bronchoalveolar lavage samples were positive for Aspergillus species in 18.5% of cases. In 59.2% of patients, the surgical risk was assessed as ASA 3. Thirty seven patients underwent lobectomy, 3 – pneumonectomy, 7 – wedgeresection, 1 – decortication, and 1 – cavernostomy.   Results : In-hospital mortality was 4.1%. Postoperative complications occurred in 63.3% of patients. The most common complications were: prolonged air leak (26.3%), arrhythmias (20.4%), residual pneumothorax (16.3%), respiratory failure (14.3%), atelectasis (12.3%), and bleeding (12.3%). Of the three patients that underwent pneumonectomy, one died, two required repeat thoracotomy because of bleeding, and all three required prolonged mechanical ventilation. Two patients died during the follow-up period. Aspergilloma did not recur in any of the patients who underwent pulmonary resection.   Conclusions : Due to the high risk of complications, surgical treatment of pulmonary aspergilloma should be restricted to symptomatic patients in whom lobectomy can be performed. The long-term results of surgical treatment are good, preoperative symptoms abate in most patients, and the rate of aspergillosis recurrence is very low.",
author="Kasprzyk, Mariusz
and Pieczyński, Kornel
and Mania, Krystian
and Gabryel, Piotr
and Piwkowski, Cezary
and Dyszkiewicz, Wojciech",
pages="99--103",
doi="10.5114/kitp.2017.68738",
url="http://dx.doi.org/10.5114/kitp.2017.68738"
}