Conservative surgery in pulmonary aspergilloma

Introduction. - Pulmonary aspergilloma is a mycotic infection due to the deposit of mycelial fibres, usually in a pre-existing cavity within the lung. Surgical resection is the treatment of choice, with anatomical resection the most practiced technique. Simple aspergillomas are becoming more and more frequent urging this review of the place of conservative surgery. Aim. - The aim of this study was to establish the characteristics of aspergillomas which may benefit from a conservative surgery. Methods. - We undertook a retrospective study of 64 cases that were operated on in the thoracic surgery unit in Abderrahmen-Mami Ariana's hospital between 1984 and 2008. Results. - Fourteen patients had conservative surgical treatment, with an atypical resection to remove the aspergilloma. The other 50 patients had undergone anatomical resection; segmental resection, lobectomy or pneumonectomy. The perioperative mortality rate was 5%. One case of aspergilloma recurrence had been recorded in a patient who had had conservative surgery for a complex aspergilloma. Conclusion. - Surgery is the only effective treatment of aspergilloma. Conservative surgery may be an alternative in simple-peripheral forms, which have a diameter less than 4 cm. (c) 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.