Hemoptysis from complex pulmonary aspergilloma treated by cavernostomy and thoracoplasty

BMC Surg. 2019 Dec 5;19(1):187. doi: 10.1186/s12893-019-0650-1.

Abstract

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 compressing materials.

Methods: A total of 63 in high-risk patients who suffered from hemoptysis due to complex pulmonary aspergilloma and underwent cavernostomy and thoracoplasty surgery from November 2011 to September 2018 at Pham Ngoc Thach hospital were evaluated prospectively studied. Patients were allocated to two groups: the table tennis ball group and tissue expander group. We evaluated at the time of before operation, 6 months and 24 months after operation.

Results: Tuberculosis was the most common comorbidity diseases in both groups. Upper lobe occupied almost in location. Hemoptysis symptoms plunged from time to time. Statistically significant Karnofsky score was observed in both groups. Postoperative pulmonary functions (FVC and FEV1) have remained in both groups at all time points. The remarkable results were no deaths related to surgery and low complications both short and long-term. 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 complex pulmonary aspergilloma with hemoptysis in high-risk patients. No mortality related to surgery and low complications were recorded. The was no inferiority when compared two compressing materials .

Keywords: Cavernostomy; Complex pulmonary Aspergilloma (CPA); Hemoptysis; Table tennis balls; Thoracoplasty; Tissue expander.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hemoptysis / etiology*
  • Humans
  • Length of Stay
  • Lung / surgery
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Aspergillosis / surgery*
  • Thoracoplasty / methods*
  • Treatment Outcome