| Popis: |
Among pulmonary fungal infections, aspergillosis poses a major challenge to thoracic surgeons. Aspergilloma classically arises in preexisting cavitary lesions secondary to previous tuberculosis; more recently, they have also been linked to other underlying lung diseases such as sarcoidosis, bronchiectasis, and emphysema. Because the effect of systemic antifungal agents is usually limited, life-threatening hemoptysis and/or deterioration of a patient’s general condition often necessitates surgical intervention. Surgical strategies for pulmonary aspergillomas range from radical pulmonary resection and semi-radical cavernostomy with or without muscle-flap transposition and thoracoplasty to conservative intracavitary instillation of antifungal agents. To select an optimal strategy, it is important to understand the nature of the patient’s aspergilloma—noninvasive or invasive (chronic necrotizing pulmonary aspergillosis), simple or complex—in association with the underlying pulmonary condition. |
