title: Lung resection in pulmonary aspergilloma: experience of a Moroccan center.
abstract: BACKGROUND
  This study was conducted to determine the efficacy of surgery in the treatment of complex aspergilloma comparatively with simple aspergilloma.
  
  
  METHODS
  From January 2006 to December 2014, 115 cases of pulmonary aspergilloma were admitted in our department. One operation on one side was counted as one case and the patients were divided into two groups. In group A: 61 cases of complex aspergilloma. In group B: 50 patients underwent 54 cases of lung resection for simple aspergilloma. People who underwent arteriography and embolization were excluded. Surgical treatment was indicated when 1) recurrent aspergilloma-related hemoptysis, 2) definite simple or complex aspergilloma and 3) a simultaneous bilateral aspergilloma.
  
  
  RESULTS
  People with complex aspergilloma were big smokers with lower BMI, and had reduced lung function parameters. The main symptoms were repeated hemoptysis, chronic cough, abundant purulent expectoration and respiratory infections. Lobectomy was the most performed indication. In group B, number of wedge resections was larger than group A with statistical significant difference (p = 0.001). In the post-operative course morbidity was higher in group A (16%) vs (9%) in group B with statistical difference (p = 0.026). The median follow-up was 30 months (range 19-52 months). The median duration of chest tube drainage was 4 days. The duration of chest tube drainage was longer in the group A (4.7 ± 1.4 versus 2.9 ± 1.3; p = 0.005). The prolonged postoperative air leakage occurred more frequently in group A (14.75%; versus 1.8% p = 0.015). In group A, 3 cases and 2 in group B underwent a secondary operation for post operative hemothorax. Bronchopleural fistula occurred exclusively in group A (n = 4).
  
  
  CONCLUSIONS
  The surgical resection should be used in a multidisciplinary approach. Preoperative Interventional therapies could optimize the conditions for the operation. Total surgical resection must be the treatment of choice of localized causative lesions.
authors.affiliation: Department of Thoracic Surgery, Mohamed V Military University Hospital, Riad 10100, Rabat, Morocco. hamoumimassine@hotmail.fr.|Center of doctoral studies, Faculty of Medecine and Pharmacy, Mohamed V University, Rabat, Morocco. hamoumimassine@hotmail.fr.
authors.forename: Mohammed Massine
authors.initials: MM
authors.lastname: El Hammoumi
authors.affiliation: Department of Thoracic Surgery, Mohamed V Military University Hospital, Riad 10100, Rabat, Morocco.
authors.forename: Omar
authors.initials: O
authors.lastname: Slaoui
authors.affiliation: Department of Thoracic Surgery, Mohamed V Military University Hospital, Riad 10100, Rabat, Morocco.
authors.forename: Fayçal
authors.initials: F
authors.lastname: El Oueriachi
authors.affiliation: Department of Thoracic Surgery, Mohamed V Military University Hospital, Riad 10100, Rabat, Morocco.|Center of doctoral studies, Faculty of Medecine and Pharmacy, Mohamed V University, Rabat, Morocco.
authors.forename: El Hassane
authors.initials: EH
authors.lastname: Kabiri
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D009018:Morocco / Q000453:epidemiology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D055732:Pulmonary Aspergillosis / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome