Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients.
Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients.
复制标题
DOI：
10.1510/icvts.2007.171579
复制
发表时间：
2008-10-01
影响因子：
--
通讯作者：
Schondube, Friedrich A
中科院分区：
文献类型：
--
作者：
Danner, Bernhard C;Didilis, Vassilios;Schondube, Friedrich A
侵袭性肺曲霉菌病是免疫抑制患者的严重并发症。手术切除可以治愈某些患者后，抗真菌治疗。回顾性分析了两所大学医院7年来10例疑似侵袭性肺曲霉菌病的患者。进行了文献综述。患者的年龄为48.1岁（平均）;免疫抑制的原因是血液疾病，7例患者接受连续治疗，3例患者接受长期皮质激素治疗。抗真菌治疗后，60%的患者进行了肺叶切除术/肺段切除术，40%的患者进行了楔形切除术。7例患者术后恢复顺利，2例患者因感染死亡，1例患者因脓胸再次手术。基础疾病标志着长期随访。局部肺侵袭性曲霉菌病切除术可治愈。必须考虑临床情况和传播，以指示手术。为了指出最佳途径，随机前瞻性研究是必要的。
Invasive pulmonary aspergillosis is a severe complication in immunosuppressed patients. Surgical resection can be curative in certain patients after antifungal treatment. Over a 7-year period, ten patients with suspected invasive pulmonary aspergillosis of two university hospitals were retrospectively reviewed. A literature review was undertaken. Patient's age was 48.1 years (mean); the cause of immunosuppression was a hematological disease with consecutive therapy in seven patients and chronically corticoid therapy in three patients. After an antifungal therapy, surgical resection was performed with lobectomy/segmentectomy in 60% and with wedge-resection in 40%. Postoperative course were uneventful in seven patients, two patients died due to infectional circumstances, and one patient was reoperated because of empyema. The underlying disease marked long-term follow-up. Resection of focal pulmonary invasive aspergillosis can be curative. Clinical circumstances and dissemination must be taken into consideration to indicate surgery. To point out the best pathway randomised prospective studies are necessary.