Un traitement antifongique périopératoire influence-t-il la morbidité postopératoire et la survie à long terme après une résection pulmonaire pour aspergillome ?

Pagès, P; Grima, Renaud; Mordant, Pierre; Grand, B.; Badia, A.; Pimpec-Barthes, Françoise Le; Bernard, Alain; Riquet, Marc

doi:10.1016/j.pneumo.2014.08.002

Cited by 4 publications

(3 citation statements)

References 24 publications

(27 reference statements)

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“…Use of antifungal agents, whether systemic or intracavitary, has shown little success in “curing” aspergilloma. [34] A review of literature reveals no consistent evidence that aspergilloma responds to antifungal agents. Furthermore, these drugs rarely achieve the minimal inhibitory concentrations within the lung cavities.…”

Section: Introductionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery for pulmonary aspergilloma

et al. 2017

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Introduction:Surgical management of pulmonary aspergilloma in symptomatic patients offers a significant chance of cure. Video-assisted thoracic surgery is a valid alternative for properly selected cases. We herein report our experience with thoracoscopic management of pulmonary aspergilloma.Patient and Methods:This retrospective analysis was performed on 41 patients operated between 2012 to 2015. The patient records were thoroughly analyzed for demography, clinical presentation, computed tomography, the procedure performed, post-operative complications and course during 6 month's follow up.Results:Out of total 41 patients, 23 (56%) were treated by VATS and 18 (44%) by thoracotomy. Average intraoperative blood loss was 214 ml (±106) in VATS group and 461 ml (±167) in thoracotomy. Mean operative time was 162 (±14) minutes in VATS and 239 (±12) minutes in thoracotomy group. In VATS group, postoperative complications were found in 5 patients and in 11 patients in the thoracotomy group. Average duration of chest tube was 5.43 () days in VATS group and 8.94 () days in thoracotomy group. Average length of hospital stay was 5.04 in VATS group and 6.55 days in thoracotomy group.Conclusions:VATS for pulmonary aspergilloma, if applicable, may be a safe and efficacious option in experienced hands. Simple aspergilloma, in particular, is considered to be a good indication for VATS. Some cases of complex aspergilloma may also be amenable to VATS. However, the long term results need to be further analyzed using a larger study group.

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Section: Introductionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery for pulmonary aspergilloma

et al. 2017

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“…However, exclusive antifungal treatment has been described with acceptable resolution rates. 5,8 Systemic azoles offer the best results. Local administration of Amphotericin by intracavitary or endobronchial instillation offers mixed results and needs further studies but may improve tissue penetration.…”

Section: Discussionmentioning

confidence: 99%

“…Adjuvant antifungal treatment is usually administrered, both systemic and inhaled, due to concern to tissue penetration. However, exclusive antifungal treatment has been described with acceptable resolution rates 5,8 . Systemic azoles offer the best results.…”

Section: Discussionmentioning

confidence: 99%

Tracheal stent aspergillosis occurring after aortic allograft of the trachea

Durliat

Locatelli-Sanchez

Wallet

et al. 2022

Transplant Infectious Dis

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Background Aspergillosis is a fungal infection with many clinical forms. Invasive aspergillosis is the most widely known severe manifestation, but other forms can need intensive care. Aim Our purpose is to report a case of tracheal aspergilloma and provide a review of the literature concerning endobronchial aspergillus. Method We report a case of tracheal aspergilloma causing tracheal obstruction in a patient admitted in the ICU for respiratory distress. The aspergilloma occurred in a tracheal stent implanted during tracheal allograft for tracheal cancer. A combination of local and systemic antifungal was used with successful result.

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Is adjuvant antifungal therapy after video-assisted thoracic surgery for pulmonary aspergilloma necessary?

Zheng

et al. 2018

J. Thorac. Dis

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Background: The aim of this current retrospective study was to assess the necessity of postoperative antifungal therapy for pulmonary aspergilloma (PA) patients who underwent video-assisted thoracic surgery (VATS) lung resection. Methods: We enrolled 22 PA patients who underwent VATS lung resection between 2014 and 2018. Of these, 12 patients were prescribed antifungal agents during the perioperative period (group A), and the other 10 were treated with surgery alone without any antifungal therapy postoperatively (group B). All patients were immunocompetent. Results: Seven patients (58.3%) developed postoperative complications in group A, including 2 cases of empyema (16.7%), 1 case of bronchopleural fistula (8.3%), 1 case of pneumonia (8.3%), 1 case of wound infection (8.3%), 1 case of bleeding (8.3%) and 1 case of atelectasis (8.3%). In group B, 3 patients (30%) developed postoperative complications, including 2 cases of pneumonia (20%) and 1 case of empyema (10%). There was no significant difference between the groups with respect to postoperative complications rates (P=0.23). The follow-up period ranged from 1 to 38 months (a median of 19 months), during which no hospital deaths, recurrence of disease or lesion relapses were noted in either group. Conclusions: Our results suggested that postoperative adjuvant antifungal therapy has limited advantages for the surgical treatment of PA in immunocompetent patients.

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Un traitement antifongique périopératoire influence-t-il la morbidité postopératoire et la survie à long terme après une résection pulmonaire pour aspergillome ?

Cited by 4 publications

References 24 publications

Video-assisted thoracoscopic surgery for pulmonary aspergilloma

Video-assisted thoracoscopic surgery for pulmonary aspergilloma

Tracheal stent aspergillosis occurring after aortic allograft of the trachea

Is adjuvant antifungal therapy after video-assisted thoracic surgery for pulmonary aspergilloma necessary?

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