Outcomes of pulmonary resection in pulmonary aspergilloma: A retrospective cohort study in a single tertiary-care hospital in Northern Thailand

To date, surgery is the best approach to maximize a cure for symptomatic aspergilloma, but this is not without risk of both morbidity and mortality. The aim of this study is to present the characteristics and outcomes of 77 patients diagnosed with aspergilloma who underwent surgery at Chiang Mai Uni...

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Bibliographic Details
Published in:Asian journal of surgery 2024-07, Vol.47 (7), p.3033-3038
Main Authors: Balasubbiah, Narendran, Saeteng, Somcharoen, Siwachat, Sophon, Thuropathum, Pradchaya, Tantraworasin, Apichat
Format: Article
Language:English
Subjects:
Aspergillosis
Fungal ball
Lung resection
Mycetoma
Perioperative complications
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Summary:To date, surgery is the best approach to maximize a cure for symptomatic aspergilloma, but this is not without risk of both morbidity and mortality. The aim of this study is to present the characteristics and outcomes of 77 patients diagnosed with aspergilloma who underwent surgery at Chiang Mai University Hospital (CMUH), and to identify risk factors for composite major postoperative complications (CMPC). This is an observational retrospective cohort study carried out at CMUH over a period of 11 years from January 1, 2010, to February 28, 2021. Patient characteristics and postoperative outcomes were studied. The primary outcomes were categorized into CMPC. Univariable and multivariable risk regression analysis were used to identify risk factors of CMPC, with risk ratio (RR) and 95% confidence intervals being calculated. There were 77 patients included in this study; 27 patients identified as having CMPC and 55 patients as a non-CMPC group. From the multivariable analysis, a factor associated with CMPC included perioperative FFP transfusion (risk ratio (RR) 1.01,95 % CI 1.01–1.02) and preoperative angiogram embolization (RR 8.42, 95 % CI 1.44–49.06) whereas immediate extubation (RR 0.22, 95% CI 0.06–0.81) was less likely to be associated with CMPC. There was a trend of increased risk of CMPC in patients received perioperative blood transfusion, but the data did not reach statistical significance. This study has identified a need for patient profiling before embarking on lung surgery for aspergilloma, to predict outcomes and allocate resources appropriately for safer surgery.
ISSN:1015-9584
DOI:10.1016/j.asjsur.2024.02.003