title: Surgical treatment for pulmonary aspergilloma: a 35-year experience in the Chinese population.
abstract: The surgical treatment of pulmonary aspergilloma is challenging and controversial. This study was designed to evaluate the clinical profile, indications and surgical outcomes of pulmonary aspergilloma operated on in our institute. A total of 256 patients with pulmonary aspergilloma underwent surgical treatment from 1975 to 2010. The patients were divided into two groups: Group A (simple aspergilloma, n = 96) and Group B (complex aspergilloma, n = 160). The principal underlying lung disease was tuberculosis (71.1%). The surgical procedures consisted of 212 lobectomies in both groups; eight cavernoplasties, 10 bilobectomies, 16 pneumonectomies and six thoracoplasties in Group B; four segmentectomies and six wedge resections in Group A. Postoperative complications occurred in 40 patients (15.6%). The major complications were residual pleural space (3.9%), prolonged air leak (3.1%), bronchopleural fistula (1.6%), excessive bleeding (1.6%), respiratory insufficiency (1.9%) and empyema (1.2%). No intraoperative deaths occurred. The overall mortality within 30 days post-operation was 1.2%, occurring only in Group B. There was no statistically significant difference in the postoperative morbidity between Groups A and B (P = 0.27). With the good selection of patients, meticulous surgical techniques and good postoperative management, aggressive surgical treatment with anti-fungal therapy for pulmonary aspergilloma is safe and effective, and can achieve favourable outcomes.
authors.affiliation: Department of Thoracic Surgery,  Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai,  People's Republic of China.
authors.forename: Qian-Kun
authors.initials: QK
authors.lastname: Chen
authors.forename: Ge-Ning
authors.initials: GN
authors.lastname: Jiang
authors.forename: Jia-An
authors.initials: JA
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001987:Bronchiectasis / Q000150:complications; D001994:Bronchogenic Cyst / Q000150:complications; D002681:China; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000150:complications; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000209:etiology; D055732:Pulmonary Aspergillosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013905:Thoracoplasty / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications; D055815:Young Adult
chemical_list: D000935:Antifungal Agents