Pulmonary aspergillosis is relatively rare disease, most commanly per-existing cavitary disease. This investigation is designed to illustrate the clinical features, preoperative diagnosis and surgical role in the management of this disease.
In retrospective review of opeative cases since Jan. 1988, total 16 cases were analysis. Peak incidence of age lies in the 3rd & 5th decade(81.3%). The common presenting symptoms were hemoptysis & blood tinged sputum(90.9%) & all cases had a
history of
treatment with antituberculous drugs, but the tuberculosis was revealed in only 3 cases in the pathologic studies on specimen after resection. The locations of lesion were upper lobes in 13 cases, lower lobe in 2 cases, and left whole lobe in 1
cases.
The operative procedures for treatment of aspergillosis were performed. The lobectomy was performed in 7 cases, lobectomy & segmentectomy in 2 cases, lobectomy & decortication in 2 cases, segmentectomy in 3 cases, bilobectomy &segmentectomy in 1
case
and pneumonectomy in case.
There was one death due to respiratory insufficiency 21 days later, postoperatively, and empyemas & residual space problems were developed in 2 & 3 cases, respectively, The empyemas were treated with open thoracostomy and the dead spaces was
filled
with
granulation tissues within 6 months.
During follow up, there was no recurrence.
In conclusion, surgical resection is the treatment of choice for symptomatic aspergillosis and needed in asymptomatic patient to prevent possible fatal sequelae in the future. (Korean J Thoracic Cardiovas Surg 1993;26:696-700)
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