Pulmoner aspergillomada cerrahi yaklaşım
Küçük Resim Yok
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Aves Yayıncılık
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Pulmoner aspergilloma, Aspergillus fumigatus’un akci¤er kavitelerinde kolonizasyonundan kaynaklanan ve hayat› tehdit eden bir hastal›kt›r. Bu çal›flma, pulmoner aspergillomada cerrahi tedavinin rolünü araflt›rmak amac› ile yap›ld›. Merkezimizde 1987 ile 2002 y›llar› aras›nda pulmoner aspergilloman›n tedavisi için 42 olguya 43 operasyon yap›ld›. Olgular›n 29’u erkek, 13’ü kad›nd› ve ortalama yafl 32 (21-68) idi. Olgular›n 38’inde (%90.5) altta yatan hastal›k tüberkülozdu. Yirmi bir (%50) olgunun gö¤üs radyografilerinde tipik olan fungus topu ve “air-crescent sign” vard›. Cerrahi endikasyonlar 29 (%69) olguda hayat› tehdit eden veya tekrarlayan hemoptizi, 12 (%28.6) olguda harap olmufl lob veya akci¤erdi. Olgular›n 26’s›na (%61.9) lobektomi (bir olguda ek olarak segmentektomi), 6’s›na pnömonektomi, 8’ine kavernomiyoplasti, 1’ine bilateral üst lobektomi ve 1’ine torakomiyoplasti yap›ld›. Postoperatif mortalite 3 (%7.1) olguda görüldü. Komplikasyonlar uzam›fl hava kaça¤› ve/veya ampiyem (5), bronkoplevral fistül (2), kanama (2) ve yara yeri infeksiyonuydu (2). Tüberküloz, pulmoner aspergilloma ile iliflkili en s›k görülen hastal›kt›r. Pulmoner aspergilloma tedavisinde cerrahi rezeksiyon en etkili tedavi yöntemidir. Genel durumu bozuk ve solunum fonksiyonlar› s›n›rl› oldu¤u için rezeksiyon yap›lamayan olgularda, kavernomiyoplasti hayat kurtar›c› bir yöntemdir.
Pulmonary aspergilloma is a potentially life-threatening disease resulting from the colonization of lung cavities by the Aspergillus fumigatus. This study was performed to find out the role of surgical treatment in pulmonary aspergillomas. In our center, between 1987 and 2002, 42 patients underwent a total of 43 operations for treatment of pulmonary aspergilloma. The patients were comprised of 29 males and 13 females, with a mean age of 32 years (range, 21- 68). The underlying lung disease was tuberculosis in 38 (90.5%) cases. There was typical fungus ball and air-crescent sign in the chest radiographies of 21 (50%) patients. Indications for surgical intervention were life-threatening or recurrent hemoptysis in 29 (69%) patients and destroyed lobe or lung in 12 patients (28.6%). Twenty-six (61.9%) lobectomies (one with associated segmentectomy), 6 pneumonectomies, 8 cavernomyoplasties, 1 bilateral upper lobectomy and 1 thoracomyoplasty were performed. There were three postoperative deaths (7.1%). Complications were, prolonged air leak and/or empyema (5), bronchopleural fistula (2), bleeding (2) and wound infection (2).Tuberculosis is the most frequent disease associated with pulmonary aspergilloma. Surgical resection is the most effective treatment in pulmonary aspergilloma. If resection can not be performed because of limited pulmonary functions and poor general condition, cavernomyoplasty should be performed as a life saving procedure.
Pulmonary aspergilloma is a potentially life-threatening disease resulting from the colonization of lung cavities by the Aspergillus fumigatus. This study was performed to find out the role of surgical treatment in pulmonary aspergillomas. In our center, between 1987 and 2002, 42 patients underwent a total of 43 operations for treatment of pulmonary aspergilloma. The patients were comprised of 29 males and 13 females, with a mean age of 32 years (range, 21- 68). The underlying lung disease was tuberculosis in 38 (90.5%) cases. There was typical fungus ball and air-crescent sign in the chest radiographies of 21 (50%) patients. Indications for surgical intervention were life-threatening or recurrent hemoptysis in 29 (69%) patients and destroyed lobe or lung in 12 patients (28.6%). Twenty-six (61.9%) lobectomies (one with associated segmentectomy), 6 pneumonectomies, 8 cavernomyoplasties, 1 bilateral upper lobectomy and 1 thoracomyoplasty were performed. There were three postoperative deaths (7.1%). Complications were, prolonged air leak and/or empyema (5), bronchopleural fistula (2), bleeding (2) and wound infection (2).Tuberculosis is the most frequent disease associated with pulmonary aspergilloma. Surgical resection is the most effective treatment in pulmonary aspergilloma. If resection can not be performed because of limited pulmonary functions and poor general condition, cavernomyoplasty should be performed as a life saving procedure.
Açıklama
Anahtar Kelimeler
Bronkopulmoner aspergillozis, Torasik cerrahi, Tüberküloz, Bronchopulmonary aspergillosis, Thoracic surgery, Tuberculosis
Kaynak
Toraks Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
6
Sayı
1
Künye
Koşar, A., Kıral, H., Örki, A., Keleş, M., Ürek, Ş., Temürtürkkan, K., Dudu, C. ve Arman, B. (2005). Pulmoner aspergillomada cerrahi yaklaşım / Surgical approach to pulmonary aspergilloma. 6(1), s. 1302-7808.
