ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Is there any change in disease presentation and surgical outcomes in patients with pulmonary aspergilloma? An evaluation of the time trend
Atilla Pekçolaklar1, Necati Çıtak2, Yunus Aksoy3, Volkan Erdoğu3, Muzaffer Metin3
1Department of Thoracic Surgery, Bursa City Hospital, Bursa, Türkiye
2Department of Thoracic Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Türkiye
3Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2022.21406
Background: This study aims to investigate the changes in the clinical and radiological presentations of pulmonary aspergilloma in patients undergoing surgery and to evaluate changes in the surgical outcomes over time.

Methods: Between January 2000 and January 2020, a total of 88 patients (69 males, 19 females; mean age: 45.4±11.2 years; range, 17 to 70 years) who underwent surgery for pulmonary aspergilloma were retrospectively analyzed. Surgeries performed were divided into two groups based on their chronological order: first period (from 2000 to 2010, n=44) and second period (from 2010 to 2020, n=44).

Results: The most frequent underlying disorder was tuberculosis (72.7%), whereas 10 patients did not have any predisposing conditions for pulmonary aspergilloma. Regarding the aspects of radiological imaging and operative findings, 22 patients had simple aspergilloma and 66 patients had complex aspergilloma. Complications and mortality rates were 33.0% and 5.7%, respectively. A statistical downward was observed in the second period compared to that in the first period regarding the rate of patients with tuberculosis history (61.4% vs. 84.1%, p=0.01). There were more patients who did not have any predisposing conditions for pulmonary aspergilloma in the second period and in the simple aspergilloma group (p=0.04 and p<0.001, respectively). Simple aspergilloma was often observed in the second period than that in the first period (31.8% vs. 18.2%). There was no significant difference between the periods regarding the type of surgical resection (p=0.506), whereas in the simple aspergilloma group, more patients underwent wedge resection (p<0.001). There were no significant differences between the periods and radiological groups in terms of complications and mortality. Patients who underwent pneumonectomy had significantly higher rates of complications and mortality (p=0.01 and p=0.03, respectively).

Conclusion: Although pulmonary aspergilloma patients who underwent surgery in the last 10 years had a lower history of tuberculosis than those who were operated in the previous 10 years, there was no change in postoperative complications and mortality rates. An increase in simple aspergilloma prevalence may reduce the rate of surgical morbidity.

Keywords : Pulmonary aspergilloma, surgery, time trend, tuberculosis
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