Les aspergillomes pulmonaires : résultats du traitement chirurgical. À propos d'une série de 206 cas

Kabiri, El Hassane; Lahlou, K.; Achir, A.; Aziz, Said Al; Meslout, A. El; Benosman, A.

doi:10.1016/s0001-4001(99)00077-x

Cited by 18 publications

(18 citation statements)

References 25 publications

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“…The improvement in survival is probably related to the most stringent criteria in the selection of patients, adequate lung capacity, the limited underlying lung disease and the extent of pulmonary resection. For the simple fungal ball operative mortality is similar to the one of the general population 4,8,10,13,18 . The cavernostomy is a surgical treatment option, especially in complex fungal ball in patients with pleuropneumonectomy indication and also in those with bilateral fungal balls.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 77%

“…The most common is the complex form, where cavities have thick walls surrounded by fibrotic lung tissue, stiff hilar structures, vascular adhesions and obliteration of the pleural cavity. The changes are observed more frequently in sequelae of pulmonary tuberculosis [7][8][9][10][11] . The volume of hemoptysis caused by the fungal ball is variable, however with frequent risk of causing death by asphyxiation.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

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Complex pulmonary aspergilloma treated by cavernostomy

Silva

Marsico

Araujo

et al. 2014

Rev. Col. Bras. Cir.

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Results 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). Conclusion Conclusion Conclusion Conclusion Conclusion: 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.

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Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 77%

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Complex pulmonary aspergilloma treated by cavernostomy

Silva

Marsico

Araujo

et al. 2014

Rev. Col. Bras. Cir.

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“…L’aspergillome broncho-pulmonaire est une pneumo-mycose opportuniste résultant le plus souvent de la colonisation de cavités parenchymateuses préexistantes détergées par un champignon du genre aspergillus [5]. Cependant, l’existence d’une cavité n’est pas obligatoire car l’aspergillus peut, grâce à des sécrétions enzymatiques, entraîner une lyse du parenchyme en particulier fragilisé par une radiothérapie antérieure [6]. Parfois même, l’aspergillome survenait sans antécédent pathologique antérieur particulier [5], ce que nous n’avons pas pu observer au cours de notre expérience.…”

Section: Discussionunclassified

“…La tuberculose pulmonaire était l’affection sous-jacente la plus fréquemment observée dans la plupart des séries [5]. Parfois d’autres étiologies peuvent être notées comme une sarcoïdose avancée, une bulle d’emphysème, un kyste hydatique détergé, des bronchectasies, voire même un abcès à pyogènes, un cancer nécrosé ou une pneumopathie excavée [6]. Dans notre étude, nous avons observé un cas d’aspergillome et cancer broncho-pulmonaire associés après tuberculose pulmonaire [8].…”

Section: Discussionunclassified

“…Dans notre série on a observé un cas d’hémoptysie de ce genre. Sur le plan biologique, la mise en évidence de l’aspergillus en particulier l’aspergillus fumigatus n’a de valeur que dans des prélèvements particuliers (produits de brossage protégé, lavage broncho-alvéolaire, expectorations protégées) [6]. Le sérodiagnostic est un examen clef.…”

Section: Discussionunclassified

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Bilan d’une cure chirurgicale d’aspergillome pulmonaire secondaire a une lesion sequellaire de tuberculose au CHU/JRA

Razafimanjato¹,

Rakotoarisoa²,

Ravoatrarilandy³

et al. 2013

Pan Afr Med J

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La prise en charge d’un aspergillome pulmonaire, dans le cas des lésions limitées accessibles, est une des activités courantes en chirurgie thoracique dans les pays endémique à la tuberculose comme Madagascar. Sur une période allant de janvier 2005 en mars 2010, 15 patients, ancien tuberculeux, atteints d’une aspergillome pulmonaire sont traités par une résection segmentaire ou une lobectomie. La circonstance de découverte repose sur la clinique par des tableaux très polymorphes. L’imagerie garde une place importante. L’examen histologique des pièces d’exérèse chirurgicale confirme le diagnostic. Tous les patients ont été opérés de manière élective. Le résultat a été pour l’ensemble des patients jugés satisfaisant. Ces patients sont suivis pendant 1 à 39 mois. L’étude des résultats à distance est encore en cours et est fondamentale si le traitement chirurgical a un effet bénéfique sur la survie et la qualité de vie des malades. Le but de ce travail a été, à partir de la revue de la littérature et de notre petite expérience, de définir quels éléments pertinents mis en exergue sur le sujet.

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Analysis of Various Treatments for Pulmonary Aspergillomas

et al. 2001

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The objective of this study was to analyze the results of various treatments for pulmonary aspergilloma and to determine the surgical indications. A total of 41 patients with pulmonary aspergilloma hospitalized at the National Minamifukuoka Chest Hospital between 1973 and 1999 were analyzed with regard to their response to treatment and long-term prognosis. Five asymptomatic patients who were untreated demonstrated no change in the clinical status of aspergilloma. Analysis of the short-term response revealed surgery to be the most effective treatment. Systemic and intracavitary injections of antifungal drugs were not definitely effective, although they had a positive effect in some patients. A survival analysis revealed that all eight patients who underwent surgery are still alive. Using the Cox proportional hazard model, it was found that the favorable prognostic factors were the absence of symptoms, the absence of a superimposed bacterial infection, and surgery. There were ten deaths: three from lung cancer and seven related to uncontrollable superimposed bacterial infections, often resulting in hemoptysis. We conclude that patients with asymptomatic pulmonary aspergillomas should be clinically observed for signs of the development of lung cancer, but do not require active treatment. On the other hand, patients who are symptomatic and have uncontrollable superimposed bacterial infection will benefit from surgery.

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Les aspergillomes pulmonaires : résultats du traitement chirurgical. À propos d'une série de 206 cas

Cited by 18 publications

References 25 publications

Complex pulmonary aspergilloma treated by cavernostomy

Complex pulmonary aspergilloma treated by cavernostomy

Bilan d’une cure chirurgicale d’aspergillome pulmonaire secondaire a une lesion sequellaire de tuberculose au CHU/JRA

Analysis of Various Treatments for Pulmonary Aspergillomas

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