[Surgical treatment of pulmonary aspergilloma--with modified conservative operation].
During the past 10 years 26 patients were operated on for pulmonary aspergilloma (20 males and six females, mean age of 55.8 years). Lung resections were performed on 13 cases (Group 1). Conservative operations were performed on the remaining cases, including one bilateral operation case (Group 2). New paragraph. The operative techniques in Group 1 were: lobectomy 11 cases of lobectomy, one case of partial resection; and one case of segmental resection. The operative techniques for Group 2 were; five cases of thoracoplasty and cavernoplasty; three cases of thoracoplasty plus cavernoplasty and muscle flap; three cases of thoracoplasty and muscle flap; one case of thoracoplasty and air-plombage; and two cases of cavernoplasty. A second operation was required in four and seven cases in Groups 1 and 2, respectively, and a third operation in two and four cases respectively. The conservative technique was used in all of additional operations required. The mean operation time and amount of blood loss were 262 min and 1,943 ml for Group 1 and 170 min and 918 ml for Group 2-being shorter and lesser for Group 2. Both the operation time and blood loss were reduced during the second and third operations. Reduction of %VC after the first operation was also less remarkable for Group 2 (-9.6%, No = 9). The advantage of using a conservative technique is that successful results can be expected without insult to the hilus and mediastinal surface in cases with compromised pulmonary functions, or in those cases which pneumonectomy or resection is difficult because of the risk of massive bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)
Otsuka
T
T
Department of Thoracic Surgery, Tokyo Metropolitan Fuchu Hospital, Japan.
Imura
Y
Y
Yamamoto
H
H
Kobayashi
T
T
D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D013905:Thoracoplasty / Q000379:methods*