Results of surgical treatment for pulmonary aspergilloma

OBJECTIVES: The purpose of this retrospective study is to analyze the results of the surgical treatment for pulmonary aspergilloma and to confirm that aggressive surgical resection can provide effective outcome for these patients. PATIENTS AND METHOD: From 1987 to 2000, 110 patients underwent thoracotomy for treatment of pulmonary aspergilloma in two hospitals. The most common indication for operation was hemoptysis (82%). Underlying diseases were tuberculosis (89%), bronchiectasis (5%), carcinoma (3%), lung tumor (1%) and none (2%). The procedures were lobectomy (74%), segmentectomy (12%), wedge resection (9%), pneumonectomy (4%) and cavernoplasty in two patients. Twenty-nine patients (26%) had severe underlying intrathoracic pathologies. RESULTS: Postoperative complications occurred in 23.6% of the patients including: empyema (n=13), bleeding (n=6), respiratory insufficiency (n=2), wound infection (n=4) and bronchopleural fistula (n=1). There was one hospital death due to panperitonitis after gastric ulcer perforation. CONCLUSIONS: We recommend early surgical resection of symptomatic aspergilloma and even asymptomatic cases with reasonable complication.