Short- and Long-term Outcome after Lung Resection for Invasive Pulmonary Aspergillosis
| Autor: | F. Bernet, Jakob Passweg, H.-R. Zerkowski, Franco Gambazzi, Michael Tamm, Peter Matt, Alois Gratwohl, James M Habicht |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty ARDS Adolescent Pleural effusion medicine.medical_treatment Neutropenia Aspergillosis Immunocompromised Host Pneumonectomy Postoperative Complications medicine Humans Child Aged Cytopenia Lung Diseases Fungal business.industry Perioperative Middle Aged medicine.disease respiratory tract diseases Surgery Pneumothorax Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 51:221-225 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-2003-42259 |
| Popis: | Background Lung resection for invasive pulmonary aspergillosis (IPA) is controversial. Neutropenia, thrombopenia and poor general condition may increase perioperative morbidity and mortality, and the redeeming benefit is questionable. Therefore we analyzed short- and long-term outcome after lung resection for IPA. Methods 41 patients with hematological disease underwent lung resection for suspected IPA: lobectomy (23 patients), wedge-resection (16) and enucleation (2). Results 4 (10%) patients developed major complications: pleural aspergillosis, bronchial stump insufficiency, severe bleeding, ARDS. 11 (27%) patients showed minor complications: pleural effusion (6), pneumothorax (2), seroma (2) and hematothorax (1). 30-day mortality was 10 % (4 of 41 patients): two died of bacterial septicemia, two of disseminated aspergillosis. One (2%) death was possibly surgery-related. IPA was cleared in 87% of patients, fungal relapse occurred in 4 (10%) patients. Overall survival was 65%, 58% and 40% at 6 months, 12 months and 5 years. Conclusion Lung resection for IPA even in profound cytopenia is feasible with acceptable morbidity and mortality. Fungal infection can be cured in more than 80 % of patients. Long-term outcome can be achieved if the hematological disease is under control. |
| Databáze: | OpenAIRE |
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