Amer Bilal, Muslim M, Tahira Nishtar, Gohar Ali, Shoaib Nabi, Ayesha Mansoor.
Surgical management of Pulmonary Aspergilloma - Peshawar experience of 45 patients.
Pak J Chest Med Jan ;11(4):3-9.

Objective: To analyze the results of surgery in the management of pulmonary aspergilloma. Place and Duration: This study was conducted in the Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from June 2002 to October 2004. Materials and Methods: It was a retrospective observational study in which the computerized clinical record of 45 patients who underwent surgery for pulmonary aspergilloma were analyzed carefully for surgical outcome. The most common presenting symptom and medication for operation was haemoptysis (80%) followed by chest pain and cough with sputum. The most common underlying lung disease was tuberculosis (88.8%) followed by bronchiectasis (6.6%), carcinoma lung (2.2%) and none (2.2%). The procedures performed for the management of pulmonary aspergilloma were lobectomy (73%), segmentectomy (15%), wedge resection (6%) and pneumonectomy (4%). All patients underwent preoperative anesthetist evaluation by anesthetist and one lung ventilation during surgery. Results: Postoperative complications occurred in 9/45 patients, of which 4 patients had prolonged air leak for more then one week, 2 patients had postop bleeding, and one patient each had empyema, wound infection and bronchopleural fistula. The patient with bronchopleural fistula later developed pneumonia, respiratory insufficiency and died on 10th postoperative day. Conclusion: We recommend early surgical resection of symptomatic pulmonary aspergilloma and even asymptomatic cases with use of one lung ventilation.

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