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Vol. 31. Issue 2.
Pages 68-72 (February 1995)
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Vol. 31. Issue 2.
Pages 68-72 (February 1995)
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Tratamiento quirúrgico del aspergiloma pulmonar
Surgical treatment of pulmonary aspergilloma
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J. Torres-Melero1, A.J. Torres, F. Hernando, J.L. Balibrea
Departamento de Cirugía. Hospital Clínico Universitario San Carlos. Madrid
M. Remezal*
* Departamento de Anatomía Patológica I. Hospital Clínico Universitario San Carlos. Madrid
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La aspergilosis pulmonar puede considerarse hoy día enfermedad oportunista ya que los Aspergillus suelen colonizar cavidades pulmonares preexistentes. La forma anatomoclínica pleuropulmonar más característica es el aspergiloma.

La hemoptisis constituye el síntoma más frecuente, siendo la radiografía de tórax el método diagnóstico más sencillo.

La idoneidad del tratamiento quirúrgico es discutida especialmente en pacientes asintomáticos y/o elevado riesgo quirúrgico.

Presentamos nuestra experiencia en el tratamiento quirúrgico de 14 pacientes intervenidos en nuestro servicio, y se valoran diversos aspectos relacionados con la clínica, el diagnóstico, la actitud terapéutica y la evolución.

En resumen, consideramos que la cirugía es el tratamiento de elección en pacientes con aspergiloma pulmonar sintomático, realizando preferentemente resecciones pulmonares y considerando operable a todo enfermo que no presente contraindicaciones generales para la cirugía.

Palabras clave:
Aspergiloma pulmonar
Hemoptisis
Resecciones pulmonares

Pulmonary aspergilloma can now be classified as an opportunistic disease given that Aspergillus tends to colonize preexisting cavities in the lung. Aspergilloma is the usual pleuropulmonary anatomical sign, hemoptysis is the most frequent sympton and a chest film is the simplest diagnostic tool. The advisability of surgery is disputed, particularly in asymptomatic patients and/or those at high surgical risk.

We describe 14 patients who underwent surgery in our department, evaluating aspects of their clinical signs, diagnosis, attitude toward treatment and the course of their disease.

We believe that for patients with symptomatic pulmonary aspergilloma, the treatment of choice is surgery, preferably lung resection. All patients who do not present contraindications for general surgery can be considered operable.

Key words:
Pulmonary aspergilloma
Hemoptysis
Lung resection
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Bibliografía
[1.]
T. Shirakusa, H. Ueda, T. Saito, et al.
Surgical treatment of pulmonary aspergilloma and aspergillus empyema.
Ann Thorac Surg, 48 (1989), pp. 779-782
[2.]
J. Izquierdo, P. Postigo, J.I. Galarza, et al.
Aspergilomas pulmonares.
Presentación de 17 casos. Arch Bronconeumol, 51 (1984), pp. 227-245
[3.]
H.C. Suen, C. Wright, D. Mathisen.
Surgical management of pulmonary aspergillosis.
Chest Surgery Clinics of North America. Vol. 3. Challenging Pulmonary Infections+,
[4.]
P. Wex, E. Utta, W. Drozdz.
Surgical treatment of pulmonary and pleuro-pulmonary Aspergillus diseases.
J. Thorac Cardiovasc Surg, 41 (1993), pp. 64-70
[5.]
F. Devé.
Une nouvelle forme anatomo-radiologique de mycose primitive: le mégacytome intrabronquiectasique.
Arch Med Chir Apar Resp, 13 (1938), pp. 337-361
[6.]
O. Monod, G. Pesie, G. Lecretain.
Les aspergillomes bronchiectasiantes.
Presse Med, 59 (1951), pp. 1.557-1.559
[7.]
R. Guijarro, A. Sánchez Palencia, A. Cueto.
Aspergilomas pulmonares.
Presentación de una serie de cinco casos. Cir Esp, XLV (1989), pp. 446-452
[8.]
J. Botella, A. García-Zarza, F. Paris, et al.
Aspergiloma pulmonar: tratamiento quirúrgico.
Cir Esp, XLVI (1989), pp. 554-561
[9.]
G. Stamatis, D. Greschuchna.
Surgery for pulmonary aspergilloma and pleural aspergillosis.
J. Thorac Cardiovasc Surg, 36 (1988), pp. 356-360
[10.]
M. Sgro, F. Barzaghi, I. Scandroglio, I. Salatino.
La chirurgia exeretica nella terapia dell’aspergilloma pomonare.
Min Chir, 43 (1988), pp. 1.205-1.208
[11.]
T.S. Jennings, T.C. Flardin.
Treatment of aspergillosis with itraconazole.
Ann Pharmacother, 27 (1993), pp. 1.206-1.211
[12.]
K. Pursell, E. Telzak, D. Armstrong.
Aspergillus species colonizadon and invasive disease with AIDS.
Clin Infect Dis, 14 (1992), pp. 141-148
[13.]
M.R. Elstad.
Aspergillosis and lung defenses.
Semin Respir Infect, 6 (1991), pp. 27-36
[14.]
G. Massard, N. Reslin, J.M. Wihlm, et al.
Pleuropulmonary aspergillomas: Clinical spectrum and results of surgical treatment.
Ann Thorac Surg, 54 (1992), pp. 1.155-1.164
[15.]
M. Muñoz, M. Rodríguez, J. Aranda, et al.
Flongos aerovagantes: Valoración y estudio en pacientes con sensibilización cutánea a los mismos.
Arch Bronconeumol, 26 (1990), pp. 252-254
[16.]
F. Smith, D. Beneck.
Localized aspergillus infectation in primary lung carcinoma. Clinical and pathological contrasts with posttuberculous intracavitary aspergilloma.
Chest, 100 (1991), pp. 554-556
[17.]
S. Andrew, M. Bhattachrhjee, D. Keenan, H. Reid.
Squamous cell carcinoma ocurring in the wall of a chronic aspergilloma.
Thorax, 46 (1991), pp. 542-543
[18.]
D. McGreggor, C. Papasian, C. Pierce.
Aspergilloma within a cavitating pulmonary adenocarcinoma.
Am J Clin Pathol, 91 (1988), pp. 100-103
[19.]
K.S. Lee, H.T. Kim, Y.H. Kim, K.O. Choe.
Treatment of hemoptysis in patients with cavitary aspergilloma of the lung: value of percutaneous instillation of amphotericin B.
Am J Roentgenol, 161 (1993), pp. 727-731
[20.]
R.C. Daly, P.C. Pairolero, J.M. Piehler, et al.
Pulmonary aspergilloma.
Results of surgical treatment. J Thorac Cardiovasc Surg, 91 (1986), pp. 981-988
[21.]
C. Hilvering, E. Stevens, N. Orie.
Fever in Aspergillus mycetoma.
Thorax, 25 (1970), pp. 19-24
[22.]
K. De Beule, P. De Doncker, G. Cauwenbergh, et al.
The treatment of Aspergillosis and aspergilloma with itraconazole, clinical results of an open international study (1982-1987).
Mycoses, 31 (1988), pp. 476-485
[23.]
M. Vizcaya, R. Vidal, J. López, et al.
Métodos diagnósticos y control evolutivo de 54 aspergilomas pulmonares.
Rev Clin Esp, 183 (1988), pp. 393-396
[24.]
J. Gea, X. Aran, Sauleda, et al.
Utilidad de la tomografía axial computadorizada en el diagnóstico del aspergiloma pulmonar.
Rev Clin Esp, 188 (1991), pp. 399-402
[25.]
J. Faux, D. Shale, D. Lane.
Precipitins and specific IgG antibody to Aspergillus fumigatus in chest unit population.
Thorax, 47 (1992), pp. 48-52
[26.]
P.K. Rohatgi, R.T. Chasse.
Endoscopio visualization of aspergilloma.
Respiration, 58 (1991), pp. 112-114
[27.]
E.A. Kimmerling, J.A. Fedrick, M.F. Tenholder.
Invasive Aspergillus nigers with fatal pulmonary oxalosis in chronic obstructive pulmonary disease.
Chest, 101 (1992), pp. 870-872
[28.]
J.W. Battaglini, G.F. Murray, B.A. Keafy, et al.
Surgical management of symptomatic pulmonary aspergilloma.
Ann Thorac Surg, 39 (1985), pp. 512-516
[29.]
S. Faulkner, R. Vernon, P. Brown, et al.
Hemoptysis and pulmonary aspergilloma: Operative versus nonoperative treatment.
Ann Thorac Surg, 25 (1978), pp. 389-392
[30.]
K. Hammerman, C. Cristianson, J. Huntington, et al.
Spontaneuslysis of aspergillomata.
Chest, 64 (1973), pp. 597-599
[31.]
S. Rao, P.G. Gurzon, M.F. Muers, D.A. Watson.
Cavernoscopic evacuation of aspergilloma: an alternative method of palliation for haemoptysis in high risk patients.
Thorax, 39 (1984), pp. 394-396
[32.]
H. Plate, M. Demischev.
Das aspergillom in thoraxchirugischen krankengut.
20 jährige ergegnisse. Zentralbl Chir, 112 (1987), pp. 116-169
[33.]
R. Landreneau, S. Hazelrigg, P.F. Ferson, et al.
thoracoscopic resection of 85 pulmonary lesions.
Ann Thorac Surg, 54 (1992), pp. 415-420
[34.]
P.L. Munk, A.D. Vellet, R.N. Rankin, et al.
Intracavitary aspergilloma: transthoracic percutaneous injection of amphotericin gelatin solution.
Radiology, 188 (1993), pp. 821-823
[35.]
H. Yamada, S. Kohno, H. Koga, et al.
Topical treatment of pulmonary aspergilloma by antifungals.
Relationship between duration of the disease and efficacy of therapy. Chest, 103 (1993), pp. 1.421-1.425
[36.]
C. Hughes, R. Waugh, D. Lindsay.
Surgery for pulmonary aspergilloma: preoperative embolisation of the bronchial circulation.
Thorax, 41 (1986), pp. 324-325
Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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