Objective To investigate the surgical indications of pulmonary aspergilloma, and to reduce postoperative complications. MethodsA total of 160 surgically treated patients with pulmonary aspergilloma were analyzed retrospectively from September 1975 to March 2006. All patients were divided into two groups: simple pulmonary aspergilloma(SPA,n=34) and complex pulmonary aspergilloma(CPA, n=126), according to the nature and extent of the underlying disease of the lung. The operative procedures included 154 pulmonectomy, 3 thoracoplasties with pulmonectomy or filling with the muscle flap, and 3 cavernostomy filling with the muscle flap. Results 156 of 160 cases had been cured with cure rate of 97.5% and no postoperative deaths. There were postoperative complications in 44 patients(27.5%) including: pneumonia(15 cases), incomplete reexpansion(12 cases), prolonged air leak(10 cases), empyema (5 cases), pulmonary abscess(5 cases), bronchopleural fistula(3 cases) and wound infection(2 cases). Postoperative complications of SPA group were lower than those in CPA group (P＜0.05). One hundred and fifty-one patients were followed up for 4 months to 5 years, no recurrence were observed. Conclusion Surgical resection for pulmonary aspergilloma should be selected first whenever the diagnosis of aspergilloma is confirmed. Objective and reliable preoperative evaluation is the key to reducing postoperative complications and surgery success. Because of minimal invasiveness, short length of hospital stay and less postoperative complications, video-assisted minithoractomy surgery may be superior to open thoracotomy in patients with localized underlying pulmonary disease and less pleural adhesions.
ObjectiveTo discuss the possibility and safety of video-assisted thoracoscope surgery for pulmonary aspergilloma. MethodsWe retrospectively analyzed the clinical data of 39 patients with pulmonary aspergilloma in Beijing Chaoyang Hospital between June 2009 and May 2014. The patients were divided into two groups according to their operation method including a conventional thoracotomy surgery group (open group, n=11) and a video-assisted thoracoscope pneumonectomy group (VATS group, n=28). There were 8 male patients and 3 female patients with age of 29-64 (50.7±9.7) years in the open group. There were 13 male patients and 15 female patients with age of 20-75 (55.4±15.3) years in the VATS group. We compared clinical effectiveness between the two groups. ResultsThe operations of all patients were performed successfully. There were statistical differences between the two groups in the average length of operative time (P=0.001), the loss of intraoperative blood (P=0.005), and the score of pain (P=0.001). There was no statistical difference in lead flow of postoperative chest (P>0.05) and the time of hospitalization (P>0.05). ConclusionVideo-assisted thoracoscope surgery in the treatment of pulmonary aspergilloma could be feasible, safe, and effective based on our study. It is worth of clinical application and popularization．