PMID: 9551514Apr 29, 1998Paper

The value of surgery in the treatment of invasive pulmonary aspergillosis in neutropenic patients

Revue des maladies respiratoires
A BernardJ P Favre

Abstract

The aim of the study is to specify the indication for surgery in the treatment of invasive pulmonary aspergillosis (API). From January 1991 to October 1996 nineteen patients who had been treated with chemotherapy and associated marrow aplasia and suffering from API were operated on. At the time of the surgical intervention all of the patients were treated with antifungal drugs. The delay between the start of their symptoms and the start of treatment was 2.6 days (range: 0-17 days). 1. The risk of a massive haemoptysis by contact between the fungal infection and the pulmonary artery led to eight urgent surgical operations: six lobectomies and two lobectomies associated with segmentectomy. The mean level of polymorphonuclear neutrophils was 296 cell/mm3 (0-1,000). Plastic surgery on the pulmonary artery was carried out in three patients. One patient died after the operation with progression of the API. The duration of postoperative stay was 13 days (6-18). 2. Planned surgery consisted of a resection of the residual mass after antifungal treatment and a diagnostic approach to the intraparenchymatous mass of indeterminate aetiology. A resection of the residual masses (in spite of antifungal treatment) was carried out in seven patie...Continue Reading

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