Hemoptysis from Complex Pulmonary Aspergilloma Treated by Cavernostomy and Thoracoplasty

Abstract

Background In high-risk patients with complex pulmonary aspergilloma but unable for lung resection, cavernostomy and thoracoplasty could be performed. This study aimed to evaluate this surgery compared two material used (table tennis ball and tissue expander) as a filler. Methods: The prospective study evaluated 63 in high-risk patients who had hemoptysis due to complex pulmonary aspergilloma that submitted to cavernostomy and thoracoplasty surgery from November 2011 to September 2018. Patients were allocated to the table tennis ball group (46 patients) and tissue expander group (17 patients). We evaluated at the time of before operation, six months and 24 months after operation. Results The most common comorbidity diseases were tuberculosis in two groups. Upper lobe occupied almost location. Hemoptysis symptoms plunged from time to time. Statistically significant Karnofsky score was observed in both groups. BMI showed slightly increasing but not statistically significant. Postoperative pulmonary functions (FVC and FEV1) have remained in both groups at all time points. The remarkable results were no death in the postoperative period, and long-term complication of surgery was low. There was no statistical significance between two groups in operative time, blood loss during operation, ICU length-stay time. Four patients died because of co-morbidity in 24 months follow-up. Conclusion: Cavernostomy and thoracoplasty was safe and effective surgery for the treatment of high-risk patients with complex pulmonary aspergilloma. There was no mortality related to surgery. The postoperative complications and long-term complication were low. The was no inferiority when compared table tennis ball group and tissue expander group. Keyword: Complex Pulmonary Aspergilloma (CPA), Hemoptysis, Cavernostomy, Thoracoplasty, Table Tennis Balls, Tissue expander,