PNEUMONECTOMY FOR CHRONIC PULMONARY ASPERGILLOSIS � A TERITIARY CENTRE ANALYSIS

Dr TELLA RAMAKRISHNA DEV; Dr MUPPIRI VIJAYA KUMAR

Volume : VII, Issue : I, January - 2017

PNEUMONECTOMY FOR CHRONIC PULMONARY ASPERGILLOSIS � A TERITIARY CENTRE ANALYSIS

Dr Tella Ramakrishna Dev, Dr Muppiri Vijaya Kumar

Abstract :

OBJECTIVE: TO analyse the indications, details of operative technique, post–operative morbidity and outcomes of patients who underwent pneumonectomy for chronic pulmonary aspergillosis.

METHODS: We retrospectively analysed the records of 15 patients who underwent pneumonectomy for chronic pulmonary aspergillosis in our institute from January 2012 to September 2016. Data were analysed for presenting symptoms, details of operative technique, development of post–operative complications and details of followup.

RESULTS: There were 15 patients 10 men and 5 women with ages ranging between 20 and 55 years .The presenting symptoms were hemoptysis in 12 patients and 3 patients with non resolving pneumonia. Pneumonectomy was left sided in 12 patients and right sided in 3 patients. Completion pneumonectomy was done in 2 patients. Intraoperatively intrapericardial isolation was done in one patient. There was no operative mortality. One patient underwent peripheral cardiopulmonary bypass to control catastrophic bleeding. 1 patient had post–operative EMPYEMA which was managed conservatively. One patient had BRONCHO PLEURAL FISTULA which was treated with PECTORALIS MAJOR MYOPLASTY.

CONCLUSION: PNEUMONECTOMY for chronic pulmonary aspergillosis has been historically considered a high risk procedure .Proper preoperative patient preparation and stabilisation, meticulous operative technique, attention to post operative sterilisation of post pneumonectomy space and perioperative usage of ANTI FUNGAL therapy can lead to satisfactory outcomes.