Surgical management of pulmonary aspergilloma. Role of single-stage cavernostomy with muscle transposition.
OBJECTIVE
We reviewed the outcome of the patients with aspergilloma who were treated surgically.


METHODS
Between July 1991 and October 1996, 11 patients with pulmonary aspergilloma underwent surgery. One underwent sequential bilateral tboracotomy and two underwent re-operation. The total number of operations was 14. Surgical procedures consisted of 5 cavernostomies with muscle transposition, 3 cavernostomies with muscle transposition and thoracoplasty, 1 lobectomy 1 pneumonectomy, 1 segmentectomy and 3 partial resections.


RESULTS
Morbidity and mortality rates were 28.6% and 7.1%, respectively Two patients who underwent cavernostomy and muscle transposition experienced a relapse of aspergilloma 19 and 29 months after the operation, respectively, but both successfully underwent re-operation, including cavernostomy. Both are free of symptoms 28 and 30 months after re-operation, respectively. All survivors except for one who died of multiple organ failure remain free of symptoms 14 to 60 months after the most recent operation.


CONCLUSIONS
Our experience was not a controlled trial and two relapsed cases had undergone cavernostomy, our series may suggest that single-stage cavernostomy with muscle transposition is a viable surgical option for patients with pulmonary aspergilloma.
Ono
N
N
Department of Thoracic Surgery, Japanese Red Cross Society Wakayama Medical Center, Japan.
Sato
K
K
Yokomise
H
H
Tamura
K
K
D000368:Aged; D001228:Aspergillosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation*; D012086:Reoperation; D013524:Surgical Flaps; D013905:Thoracoplasty / Q000379:methods; D013907:Thoracostomy / Q000379:methods*; D016896:Treatment Outcome