Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study
Abstract Background The reported experience of surgical treatment for chronic pulmonary aspergillosis (CPA) mainly focused on simple aspergilloma (SA), few about other types of CPA. The present study aims to evaluate the outcomes of surgical treatment for different types of CPA. Methods We performed...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-01-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-022-01836-z |
| _version_ | 1811191553295646720 |
|---|---|
| author | ChangMing Shen GaoFeng Qiao Cheng Wang Feng Jin YunZeng Zhang |
| author_facet | ChangMing Shen GaoFeng Qiao Cheng Wang Feng Jin YunZeng Zhang |
| author_sort | ChangMing Shen |
| collection | DOAJ |
| description | Abstract Background The reported experience of surgical treatment for chronic pulmonary aspergillosis (CPA) mainly focused on simple aspergilloma (SA), few about other types of CPA. The present study aims to evaluate the outcomes of surgical treatment for different types of CPA. Methods We performed a retrospective analysis of 85 patients with CPA who underwent surgery from 2014 to 2020 at Shandong Provincial Chest Hospital. The patients were divided into four types, including SA, chronic cavitary pulmonary aspergillosis (CCPA), chronic fibrosing pulmonary aspergillosis (CFPA), aspergillus nodule (AN). We collected and analyzed the preoperative, perioperative, and postoperative data to evaluate the outcomes of surgical treatment of different types of CPA. Results The four groups had similar age (p = 0.22), symptoms (p = 0.36), lesion location (p = 0.09), VATS rate (p = 0.08), recurrence rate (p = 0.95), and had significant difference in surgical procedures (p < 0.01), time of surgery (p < 0.01), intraoperative blood loss (p < 0.01), postoperative complication (p = 0.01). CFPA (P = 0.01), longer surgical time (P = 0.001), and more intraoperative blood loss (P = 0.004) were risk factors of postoperative complication, more intraoperative blood loss (> 400 ml) was the independent risk factor (OR 13.5, 95% CI 1.6–112.1, P = 0.02). 6 patients relapsed after surgery with a recurrence rate of 7.1%. The mean time to relapse was 14.8 months (2–30 months) after surgery. Relapse occurred in 2 SA patients, 3 CCPA, and 1 CFPA, respectively, while none of the AN patients relapsed. No risk factor for recurrence was found. Conclusions Surgical resection seems safe and effective in the treatment of SA, AN, CCPA with a low complication and recurrence rate, while surgery for CFPA should be limited to selected patients because of its higher complication rate. |
| first_indexed | 2024-04-11T18:12:56Z |
| format | Article |
| id | doaj.art-6b4f87a6143d458bbd0c0b5e09fc976a |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-11T18:12:56Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-6b4f87a6143d458bbd0c0b5e09fc976a2022-12-22T04:10:02ZengBMCBMC Pulmonary Medicine1471-24662022-01-012211710.1186/s12890-022-01836-zOutcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort studyChangMing Shen0GaoFeng Qiao1Cheng Wang2Feng Jin3YunZeng Zhang4Department of Thoracic Surgery, Shandong Public Health Clinical CenterDepartment of Thoracic Surgery, Shandong Public Health Clinical CenterDepartment of Thoracic Surgery, Shandong Public Health Clinical CenterDepartment of Thoracic Surgery, Shandong Public Health Clinical CenterDepartment of Thoracic Surgery, Shandong Public Health Clinical CenterAbstract Background The reported experience of surgical treatment for chronic pulmonary aspergillosis (CPA) mainly focused on simple aspergilloma (SA), few about other types of CPA. The present study aims to evaluate the outcomes of surgical treatment for different types of CPA. Methods We performed a retrospective analysis of 85 patients with CPA who underwent surgery from 2014 to 2020 at Shandong Provincial Chest Hospital. The patients were divided into four types, including SA, chronic cavitary pulmonary aspergillosis (CCPA), chronic fibrosing pulmonary aspergillosis (CFPA), aspergillus nodule (AN). We collected and analyzed the preoperative, perioperative, and postoperative data to evaluate the outcomes of surgical treatment of different types of CPA. Results The four groups had similar age (p = 0.22), symptoms (p = 0.36), lesion location (p = 0.09), VATS rate (p = 0.08), recurrence rate (p = 0.95), and had significant difference in surgical procedures (p < 0.01), time of surgery (p < 0.01), intraoperative blood loss (p < 0.01), postoperative complication (p = 0.01). CFPA (P = 0.01), longer surgical time (P = 0.001), and more intraoperative blood loss (P = 0.004) were risk factors of postoperative complication, more intraoperative blood loss (> 400 ml) was the independent risk factor (OR 13.5, 95% CI 1.6–112.1, P = 0.02). 6 patients relapsed after surgery with a recurrence rate of 7.1%. The mean time to relapse was 14.8 months (2–30 months) after surgery. Relapse occurred in 2 SA patients, 3 CCPA, and 1 CFPA, respectively, while none of the AN patients relapsed. No risk factor for recurrence was found. Conclusions Surgical resection seems safe and effective in the treatment of SA, AN, CCPA with a low complication and recurrence rate, while surgery for CFPA should be limited to selected patients because of its higher complication rate.https://doi.org/10.1186/s12890-022-01836-zChronic pulmonary aspergillosisSurgeryOutcome |
| spellingShingle | ChangMing Shen GaoFeng Qiao Cheng Wang Feng Jin YunZeng Zhang Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study BMC Pulmonary Medicine Chronic pulmonary aspergillosis Surgery Outcome |
| title | Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study |
| title_full | Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study |
| title_fullStr | Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study |
| title_full_unstemmed | Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study |
| title_short | Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study |
| title_sort | outcomes of surgery for different types of chronic pulmonary aspergillosis results from a single center retrospective cohort study |
| topic | Chronic pulmonary aspergillosis Surgery Outcome |
| url | https://doi.org/10.1186/s12890-022-01836-z |
| work_keys_str_mv | AT changmingshen outcomesofsurgeryfordifferenttypesofchronicpulmonaryaspergillosisresultsfromasinglecenterretrospectivecohortstudy AT gaofengqiao outcomesofsurgeryfordifferenttypesofchronicpulmonaryaspergillosisresultsfromasinglecenterretrospectivecohortstudy AT chengwang outcomesofsurgeryfordifferenttypesofchronicpulmonaryaspergillosisresultsfromasinglecenterretrospectivecohortstudy AT fengjin outcomesofsurgeryfordifferenttypesofchronicpulmonaryaspergillosisresultsfromasinglecenterretrospectivecohortstudy AT yunzengzhang outcomesofsurgeryfordifferenttypesofchronicpulmonaryaspergillosisresultsfromasinglecenterretrospectivecohortstudy |