@article {NebikerP2399, author = {Christian Nebiker and Didier Lardinois and Lilian Junker and Franco Gambazzi and Joerg Halter and Jakob Passweg and Daiana Stolz and Maja Weisser and Lukas Bubendorf and Alois Gratwohl and Michael Tamm}, title = {Lung resection in hematologic patients with pulmonary invasive fungal disease: Changing pattern in recent years}, volume = {40}, number = {Suppl 56}, elocation-id = {P2399}, year = {2012}, publisher = {European Respiratory Society}, abstract = {Pulmonary invasive fungal disease (IFD) is a frequent complication in patients with hematologic malignancies. We analysed the outcome of 71 hematologic patients undergoing lung resection for suspected pulmonary IFD at a single centre and we compared patients operated before 2002 (group A n=41) with those undergoing surgery after 2002 (group B; n=30). Forty-four patients were neutropenic and 41 had a platelet count below 50 x 109/L. 45 non-anatomical resections and 26 lobectomies were performed. Fungal infection was histologically proven in 53 patients. Reoperation was needed in 4 cases: bronchial stump dehiscence, persistent air leak, chylothorax and seroma. Minor complications at the site of surgery occurred in 14 cases. In only two cases there was an uncontrolled disseminated fungal infection. Overall mortality at 30 days was 7\% (5/71. The age was significantly higher (group B 40y versus group A 49y, p=0.0239) in the recently operated patients and a significant difference in ASA score (score III/IV 17\% in group A versus 90\% in group B, p\<0.0001) was found between the two groups. Recently operated patients underwent VATS in 47\% of cases as compared to 5\% in group A. In contrast to group A there were 6 cases of rare fungal infections in group B (2 Homographiella, 2 Rhizopus, Mucor; Zygomucetes).Conclusion: Lung resection is a therapeutic option for hematological patients suffering from pulmonary fungal infection with an acceptable morbidity and mortality. In recent years patients were older, sicker, VATS was performed more often and in a considerable number of cases rare fungi could be detected.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/40/Suppl_56/P2399}, eprint = {https://erj.ersjournals.com/content/40/Suppl_56/P2399.full.pdf}, journal = {European Respiratory Journal} }