Video-assisted thoracoscopic surgery for pulmonary aspergilloma

Kumar, Arvind; Asaf, Belal Bin; Puri, Harsh Vardhan; Lingaraju, Vijay Cholenahalli; Siddiqui, Sabah; Venkatesh, Pulle Mohan; Sood, Jayashree

doi:10.4103/0970-2113.209232

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…VATS for PA, if applicable, might be superior to open surgery in terms of safety and efficacy (7,19,23,26). Many studies comparing VATS with thoracotomy have shown that VATS has the advantages in terms of less pain, fewer complications, less incision, and shorter hospitalization (7,19,26,27). Surgical removal is generally performed by an open surgery because of obvious pleural adhesions and calcified lymph nodes located near pulmonary arteries and veins.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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

Zheng

et al. 2018

J. Thorac. Dis

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“…However, studies showed that radical resection of the affected areas had effectively improved patient outcomes. Because of this argument, many case series studies advocate a standard thoracotomy and lobectomy to be the preferred surgical procedures ( 7 – 11 , 18 – 23 ). In this series, lobectomy was done for 44.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…At present, there is a considerable controversy about the optimal treatment for PA, primarily because the natural history of the lesion is not well defined. Moreover, high morbidity and mortality have been reported from some surgical series (11)(12)(13). However, the current globally accepted mainstay of treatment is surgery and medical options have shown limited role.…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcome of Chronic Pulmonary Aspergilloma: An Experience from Two Tertiary Referral Hospitals in Addis Ababa, Ethiopia

Alemu

2020

Ethiop J Health Sci

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Background: Surgical management of pulmonary aspergillosis is challenging and controversial. This study is designed to assess the clinical profile, indications and surgical outcome of Pulmonary aspergilloma.Methods: A retrospective cross-sectional analysis of 72 patients who underwent pulmonary resection for pulmonary aspergilloma over the period from November, 2014, to November, 2019 was done. Data on demographic, clinical and surgical out come were retrieved. Analysis was done using SPSS version 23. Chi-square test was used to assess for significance of the association between variables and surgical outcome.Results: There were 46(63.9%) males and 26(36.1%) female patients with a mean age of 35.2+/-11.6 years (Range 16– 65 years). All patients were previously treated for tuberculosis. Cough, hemoptysis, and shortness of breath were the main symptoms identified. A ball of fungus together with the surrounding lung was removed. Accordingly, 32(44,4%) lobectomies, 12(16.7%) pneumonectomy, 7(9.7%) Bi-lobectomy,and 21(29.2%) cavernostomy were done. Intraoperative and Postoperative complications were seen in 8(11.1%) and 21(29.1%) patients respectively. Major morbidity encounters included massive intraoperative blood loss, prolonged air leak, empyema, air space, bronchopleural fistula, and wound infection. The hospital mortality was 3(4.2%) and the average hospital stay was 14.8days. Postoperative complications were evaluated for the difference in socio-demographic characteristics and other variables and a statistically significant difference was detected only for the location of aspergilloma, site of the lung involved and type of surgery done. (P-value <0.05.)Conclusion: Pulmonary resection done for pulmonary aspergilloma showed favorable outcomes when done with good patient selection, meticulous surgical techniques, and good postoperative management. However, its long term outcome and role of antifungal treatment as adjunctive therapy for surgical resection need further investigation.

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“…Many studies had been carried out to confirm that surgical treatment (almost surgical resection) of pulmonary aspergilloma brought out many advantages such as preventing recurrent hemoptysis, and excellent long-term results [2,3,8,21]. Although modern technology such as Robotic resection of lung used to get further advantages [22] but less invasive surgery such as sub-lobar resection and video-assisted thoracoscopic surgery (VATS) was more preferred with good results just in patients, who had simple pulmonary aspergilloma [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Hemoptysis from Complex Pulmonary Aspergilloma Treated by Cavernostomy and Thoracoplasty

Giang¹,

Dũng²,

Hien³

et al. 2019

Preprint

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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,

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Video-assisted thoracoscopic surgery for pulmonary aspergilloma

Cited by 13 publications

References 32 publications

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

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

Surgical Outcome of Chronic Pulmonary Aspergilloma: An Experience from Two Tertiary Referral Hospitals in Addis Ababa, Ethiopia

Hemoptysis from Complex Pulmonary Aspergilloma Treated by Cavernostomy and Thoracoplasty

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