Abstract
Introduction: The treatment of hemoptysis secondary to an isolated fungal ball in a post infective cavity, when the rest of the lungs are well preserved, is surgical removal of the lobe, in order to prevent the complication of massive hemoptysis, which can be unpredictable and fatal.
Objective: To assess the outcome of early referral for surgery for patients of aspergilloma who presented with massive hemoptysis.
Methods: 12 patients presented with massive hemoptysis (defined as > 500 ml of blood) secondary to aspergilloma, demonstrated on CT Thorax, between January 2012 to December 2012. They were referred for early surgical management. All 12 patients underwent lobectomy (VATS or robotic) of Aspergilloma .
Results: Age group was 35 to 78 years (mean 48 years). 8 males and 4 females. Patients received antituberculous drugs for at least 6 weeks. Voriconozole was given 2 weeks prior to surgery. We continued the patients with conservative management with voriconazole for three month and ATT.Chest X-ray showed complete lung expansion.One patient died with multi organ failure and fungal septicemia on day 25.
Conclusion: The early surgical referral for surgery has good clinical outcomes. This is economical and health friendly for patients if decision is taken early with availability of Robotic and VATS Resection of Lung which is technically possible.
- Copyright ©ERS 2015
