Feasibility of surgery for pulmonary aspergilloma: analysis of the operative modes

  • Kazuyuki Komori
  • Aritoshi Hattori
  • Takeshi Matsunaga
  • Kazuya Takamochi
  • Shiaki Oh
  • Kenji Suzuki
Original Article



We evaluated the feasibility of surgery for pulmonary aspergilloma.


We retrospectively evaluated 35 surgical patients with pulmonary aspergilloma. The clinical characteristics and perioperative surgical morbidity were compared based on the operative modes. Preoperative artery embolization (PAE) was selectively performed to reduce the expected surgical stress caused by intraoperative blood loss.


The cohort comprised 19 males and 16 females with a mean age of 56 years. Lobectomy was performed in 22 patients, segmentectomy in 5, wedge resection in 4, and palliative surgery in 4. Postoperative morbidities were found in 12 (34%) patients, however, life-threatening complications or resurgence of the infection after surgery never occurred. PAE was performed in 9 (26%). Intrathoracic adhesions were significantly observed in patients who underwent PAE (p = 0.003), however, operative time and intraoperative blood loss were not significantly different between the patients with and without PAE (operative time, 202 vs. 164 min, p = 0.143: blood loss, 173 vs. 195 ml, p = 0.871). There was no 30-day mortality at a median follow-up period of 41.5 months.


Surgical results for pulmonary aspergilloma were feasible and the postoperative morbidities were acceptable. PAE was considered effective in lessening surgical stress.


Pulmonary aspergilloma Surgical resection Preoperative artery embolization Outcome 


Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.


  1. 1.
    David WD, Jacques C, Catherine B-A, Florence A, Arunaloke C, Stijin B, et al. Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur Respir J. 2016;47:45–68.CrossRefGoogle Scholar
  2. 2.
    Muniappan A, Tapias LF, Butala P, Wain JC, Wright CD, Donahue DM, et al. Surgical therapy of pulmonary aspergillomas: a 30-year North American experience. Ann Thorac Surg. 2014;97:432–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Hinson KFW, Moon AJ, Plummer NS. Bronchopulmonary aspergillosis: review and report of eight cases. Thorax. 1952;7:317–33.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Belcher JR, Plummer NS. Surgery in broncho-pulmonary aspergillosis. Br J Dis Chest. 1960;54:335–41.CrossRefGoogle Scholar
  5. 5.
    Jewkes J, Kay PH, Paneth M, Citron K. Pulmonary aspergilloma analysis of prognosis in relation to hemoptysis and survey of treatment. Thorax. 1983;38:572–8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Shigeru Kohno, Kazuo Tamura, Yoshihito Niki, Koichi Izumikawa, Shinichi Oka, Kenji Ogawa, et al. Executive summary of Japanese domestic guidelines for management of deep-seated mycosis 2014. Med Mycol J. 2016;57:117–163CrossRefGoogle Scholar
  7. 7.
    Charles T, Burke MA, Mauro. Bronchial artery embolization. Semin intervent Radiol. 2004;21:43–8.CrossRefGoogle Scholar
  8. 8.
    Yoo DH, Yoon CJ, Kang S-G, Burke CT, Lee JH, Lee C-T. Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate. Am J Roentgenol. 2011;196:199–204.CrossRefGoogle Scholar
  9. 9.
    Lee JG, Lee CY, Park IK, Kim DJ, Chang J, Kim SK, et al. Pulmonary aspergilloma: analysis of prognosis in relation to symptoms and treatment. J Thorac Cardiovasuc Surg. 2009;138:820–5.CrossRefGoogle Scholar
  10. 10.
    Dariusz S, Kazimierz G. Surgery for pulmonary aspergilloma in immunocompetent patients: no benefit from adjuvant antifungal pharmacotherapy. Ann Thorac Surg. 2010;89:1603–11.CrossRefGoogle Scholar
  11. 11.
    Chun JY, Belli AM. Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolization for the management of hemoptysis. Eur Radiol. 2010;20:558–65.CrossRefPubMedGoogle Scholar
  12. 12.
    Akbari JG, Varma PK, Neema PK, Menon MU, Neelakandhan KS. Clinical profile and surgical outcome for pulmonary aspergilloma: a single center experience. Ann Thorac Surg. 2005;80:1067–72.CrossRefPubMedGoogle Scholar
  13. 13.
    Shiraishi Y, Katsuragi N, Nakajima Y, Hashizume M, Takahashi N, Miyasaka Y. Pneumonectomy for complex aspergilloma: is it still dangerous? Eur J Cardiothorac Surg. 2006;29:9–13.CrossRefPubMedGoogle Scholar
  14. 14.
    Brik A, Salem AM, Kamel AR, Abdel-Sadek M, Essa M, Sharawy ME, et al. Surgical outcome of pulmonary aspergilloma. Eur J Cardiothorac Surg. 2008;34:882–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Khan MA, Dar AM, Kawoosa NU, Ahangar AG, Lone GN, Bashir G, et al. Clinical profile and surgical outcome for pulmonary aspergilloma: nine year retrospective observational study in a tertiary care hospital. Int J Surg. 2011;9:267–71.CrossRefPubMedGoogle Scholar
  16. 16.
    El Hammoumi MM, Slaoui O, El Oueriachi F, Kabiri EH. Lung resection in pulmonary aspergilloma: experience of a Moroccan center. BMC Surg. 2015;15:114.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  1. 1.Department of General Thoracic SurgeryJuntendo University School of MedicineTokyoJapan

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