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Ann Thorac Surg 2005;80:1067-1072
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

Clinical Profile and Surgical Outcome for Pulmonary Aspergilloma: A Single Center Experience

^a Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
^b Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India

Accepted for publication March 16, 2005.

^_* Address reprint requests to Dr Varma, B-8, New Faculty Quarters, Chitra Staff Quarters, Poonthi Road, Thiruvananthapuram, Kerala 695 011, India (Email: pkvarma{at}sctimst.ker.nic.in; varmapk{at}gmail.com).

BACKGROUND: This retrospective study was designed to study the clinical profile, indications, postoperative complications and long-term outcome of pulmonary aspergilloma operated in our institute.

METHODS: From 1985 to 2003, 60 patients underwent surgery for pulmonary aspergilloma at Sree Chitra Tirunal Institute for Medical Sciences and Technology.

RESULTS: The group consisted of 36 male patients and 24 female patients with a mean age of 42.7 ± 11.8 years. The most common indication for surgery was hemoptysis (93.3%). The common underlying lung diseases were tuberculosis (45%), bronchiectasis (28.3%), and lung abscess (11.6%). Fourteen patients (23%) had simple aspergilloma (SA) and 46 (77%) had complex aspergilloma (CA). The procedures performed were lobectomy (n = 55), pneumonectomy (n = 2), segmental resection (n = 2), and cavernoplasty (n = 2). One patient underwent bilateral lobectomy at 14 months interval. The operative mortality was 4.3% and 0% in CA and SA, respectively (p = 1.0). Major complications occurred in 26.1% patients of CA, whereas none occurred in SA (p = 0.052). The complications included bleeding (n = 2), prolonged air leak (n = 4), empyema (n = 4), repeated pneumothorax (n = 1), and wound dehiscence (n = 1). Three patients needed thoracoplasty. The mean follow-up period was 40 ± 24 months. The actuarial survival at 10 years was 78% and 92% for CA and SA, respectively. There was no recurrence of disease or hemoptysis.

CONCLUSIONS: Surgical resection of pulmonary aspergilloma prevents recurrence of hemoptysis. Complex aspergilloma resection was associated with low mortality but significant morbidity, whereas SA had no associated early mortality and morbidity. Long-term outcome is good for SA and satisfactory for CA.

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