Complex pulmonary aspergilloma treated by cavernostomy.
OBJECTIVE
To evaluate the effectiveness of cavernostomy in patients with complex fungal balls.


METHODS
We analyzed the medical records of patients undergoing cavernostomy between January 2005 and May 2013, evaluating: age, gender, preoperative signs and symptoms, predisposing disease, preoperative tests, location of the aspergilloma, etiologic agent, cavernostomy indication, postoperative outcome.


RESULTS
Ten patients were male. The mean age was 42.9 years (34-56). The most frequent symptom was repeated pulmonary bleeding. Cavernostomy was proposed for patients at high risk for lung resection. It was performed in 17 patients and all of them had pulmonary tuberculosis sequelae, with cavitations. The indication in all cases was hemoptysis and elimination of phlegm. The cavernostomies were performed in a single surgical procedure. In all 17 patients the cavity was left open after the withdrawal of the mycetoma. In all patients hemoptysis ceased immediately. Operative mortality was 9.5% (1).


CONCLUSIONS
cavernostomy is an effective treatment alternative in patients at high risk. It may be useful in some patients with complex aspergilloma, irrespective of lung function or bilateral disease. It is technically easy, has low-risk, saves parenchyma, and may be performed in a single operative time.
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Paula Dos Santos Marsico Pereira da
Pdos S
Silva
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Giovanni Antonio
GA
Marsico
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Marcell Alex Ferraz
MA
Araujo
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Fernando Soares Vannucci
FS
Braz
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Heron Teixeira Andrade dos
HT
Santos
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Gustavo Lucas
GL
Loureiro
Andaraí Federal Hospital, Ministry of Health, Rio de Janeiro, RJ, Brazil.
Anderson
A
Fontes
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000601:surgery*; D012189:Retrospective Studies; D013908:Thoracotomy; D016896:Treatment Outcome