Volume 6, Issue 5, September 2020, Page: 67-72
Evolution of Surgery Offered to Aspergilloma over 2 Decades, Institutional Report
Hysam Abdelmohty, Cardiothoracic Surgery Department, Mansoura University, Mansoura, Egypt
Salah Eldin Khalaf, Cardiothoracic Surgery Department, Mansoura University, Mansoura, Egypt
Walid Hassan, Cardiothoracic Surgery Department, Mansoura University, Mansoura, Egypt
Ahmed Mostafa, Cardiothoracic Surgery Department, Mansoura University, Mansoura, Egypt
Mohamed-Adel Elanwar, Cardiothoracic Surgery Department, Cairo University, Cairo, Egypt
Received: Oct. 16, 2020;       Accepted: Oct. 26, 2020;       Published: Nov. 9, 2020
DOI: 10.11648/j.ijcts.20200605.12      View  38      Downloads  17
Abstract
Background: Aspergilloma is the localized form of pulmonary colonization by Aspergillus species, which often hosted within a pre-existing cavitary lesion. The Aspergilloma (commonly known as mycetoma or fungus ball) consists of fungal hyphae, aggregates of inflammatory cells, fibrin threads, and destructed tissues debris. Aspergillus Fumigatu is the commonest species responsible for such lesions. In this study, over 20 years, data were collected for examination, on the outcomes of surgery for pulmonary Aspergilloma. Methods: Retrospective study of 54 patients, dating from January 1996 and December, 2015. Each patient’s preoperative, diagnostic, operative, postoperative and follow up data was collected for analysis. Results: Findings of 54 patients who underwent surgery for Aspergilloma, 47 had clinical diagnosis. While remaining 7 were confirmed post-resection. The median age was 46.3±7.8 (aged 17-64 years). Risk assessment identified that greater probability for the Left Lung to be infected and increase if gender was male (2.6:1). The main presentation was hemoptysis, seen in 70.4% of cases, while symptoms of cough and expectoration occurred in 83.3% of them. The most prevalent predisposing factor was tuberculosis (TB), present in 57.4% of cases. The indication for surgery was recurrent hemoptysis, asymptomatic simple Aspergilloma and complex Aspergilloma. All the patients underwent pulmonary resection, with 82.5% of cases having lobectomy. The main postoperative complication was prolonged air leak 29.6% (16/54). The in-hospital mortality rate was 7.5% (6/54) patients. Conclusion: Surgery offered to Aspergilloma patients (fungus ball) brought beneficial results with an acceptable morbidity. The mortality observed within these cases, was predominantly due to high risk patients, with complex Aspergillosis. Recommendations for a multidisciplinary approach, in future cases, are paramount for better selection criteria.
Keywords
Fungus Ball, Hyphae, Aspergilloma, Cavity, Hemoptysis, Lobectomy
To cite this article
Hysam Abdelmohty, Salah Eldin Khalaf, Walid Hassan, Ahmed Mostafa, Mohamed-Adel Elanwar, Evolution of Surgery Offered to Aspergilloma over 2 Decades, Institutional Report, International Journal of Cardiovascular and Thoracic Surgery. Vol. 6, No. 5, 2020, pp. 67-72. doi: 10.11648/j.ijcts.20200605.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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