title: Cavernostomy x resection for pulmonary aspergilloma: a 32-year history.
abstract: BACKGROUND
  The most adequate surgical technique for the treatment of pulmonary aspergilloma is still controversial. This study compared two groups of patients submitted to cavernostomy and pulmonary parenchyma resection.
  
  
  METHODS
  Cases of pulmonary aspergilloma operated upon between 1979 and 2010 were analyzed retrospectively. Group 1 consisted of patients submitted to cavernostomy and group 2 of patients submitted to pulmonary parenchyma resection. The following variables were compared between groups: gender, age, number of hospitalizations, pre- and postoperative length of hospital stay, time of follow-up, location and type of aspergilloma, preoperative symptoms, underlying disease, type of fungus, preoperative pulmonary function, postoperative complications, patient progression, and associated diseases.
  
  
  RESULTS
  A total of 208 patients with pulmonary aspergilloma were studied (111 in group 1 and 97 in group 2). Group 1 was older than group 2. The number of hospitalizations, length of hospital stay and time of follow-up were higher in group 1. Hemoptysis was the most frequent preoperative symptom in group 1. Preoperative respiratory malfunction was more severe in group 1. Hemorrhagic complications and recurrence were more frequent in group 1 and infectious complications and residual pleural space were more common in group 2. Postoperative dyspnea was more frequent in group 2. Patient progression was similar in the two groups. No difference in the other factors was observed between groups.
  
  
  CONCLUSIONS
  Older patients with severe preoperative respiratory malfunction and peripheral pulmonary aspergilloma should be submitted to cavernostomy. The remaining patients can be treated by pulmonary resection.
authors.affiliation: Department of Thoracic Surgery, Júlia Kubitschek Hospital, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazi. jorgemiguels@ig.com.br
authors.forename: Jorge Ms
authors.initials: JM
authors.lastname: Cesar
authors.forename: Jose S
authors.initials: JS
authors.lastname: Resende
authors.forename: Nilson F
authors.initials: NF
authors.lastname: Amaral
authors.forename: Carla Ms
authors.initials: CM
authors.lastname: Alves
authors.forename: Alyne F
authors.initials: AF
authors.lastname: Vilhena
authors.forename: Frederico L
authors.initials: FL
authors.lastname: Silva
mesh_terms: D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D055732:Pulmonary Aspergillosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome