Lung resection and application of latissimus dorsi muscle flap for pulmonary aspergilloma: Case report

Yıl 2013, Cilt: 40 Sayı: 2, 310 - 312, 01.06.2013

Ozan Usluer Onur Akçay Özgür Samancılar Şeyda Örs Kaya

https://doi.org/10.5798/diclemedj.0921.2013.02.0278

Öz

Aspergilloma, is the most common form of aspergillus infection that presents as parenchymal cavitary lesion with saprophytic colonization. This disease is associated with variety of lung diseases such as tuberculosis, sarcoidosis and bronchiectasis. The patient in this study with tuberculosis was diagnosed 12 years ago and treated for six months. Most frequently referred symptom is hemoptysis. Aspergilloma get a diagnosis with chest x-ray and thorax computerized tomoghraphy. In treatment usually anatomic resection is performed, bronchial stump is supported and the remaining space is filled with a flap. The pateint was admitted to our hospital with hemoptysis and left upper lobectomy was performed due to cavitary lesion and bronchial stump was supported with latissimus dorsi muscle flap. The postoperative period was uneventful with no reccurrence so far.

Anahtar Kelimeler

Bronchopulmonary aspergillosis, thoracic surgery, tuberculosis

Pulmoner aspergilloma nedeniyle akciğer rezeksiyonu ve latissimus dorsi kas flebi uygulaması: Olgu sunumu

Öz

Aspergilloma, aspergillus enfeksiyonunun en sık formu olup parankimal kaviteye saprofitik kolonizasyon ile görülür. Bu durum, başta tüberküloz olmak üzere bronşektazi ve sarkoidoz gibi çeşitli akciğer hastalıkları ile birliktelik gösterebilir. Hastanın anamnezinde on iki yıl önce tüberküloz tanı ve tedavi öyküsü mevcuttu. En sık başvuru nedeni hemoptizidir. Aspergilloma tanısı göğüs radyografisi ve toraks bilgisayarlı tomografisi ile konulur. Aspergilloma cerrahisinde en sık anatomik rezeksiyon uygulanır ve toraks kavitesini doldurmak ve bronş fistülünü önlemek için flep uygulanabilir. Hemoptizi yakınmasıyla başvuran hastaya kaviter lezyon nedeniyle sol üst lobektomi uygulandı ve latissimus dorsi kas flebi ile bronş güdüğü desteklendi. Postoperatif dönemde komplikasyon izlenmeyen hastanın takiplerinde nüks saptanmadı.

Anahtar Kelimeler

Bronkopulmoner aspergillozis, göğüs cerrahi, tüberküloz

Kaynakça

• Kurul İC, Demircan S, Yazıcı Ü, et al. Surgical manage- ment of pulmonary aspergilloma. Asian Card Thor Ann 2004;12:320-323.
• Abolhoda A, Bui TD, Milliken JC, et al. Pedicled latissimus dorsi muscle flap in thoracic surgery. Texas Heart Ins J 2009;36:298-302.
• Babatasi G, Massetti M, Chapelier A, et al. Surgical treat- ment of pulmonary aspergilloma: current outcome. J Tho- rac Cardiovasc Surg 2000;119:906-912.
• Demir A, Günlüoğlu MZ, Turna A, et al. Analysis of Surgical Treatment for Pulmonary Aspergilloma. Asian Card Thor Ann 2006;14:407-411.
• Lampo N, Spiliopoulos A, Licker M, et al. Management of postpneumonectomy Aspergillus empyema extending into the thoracic wall: a plea for radical surgery and caution when using liposomal amphotericin B. Interact Cardiovasc Thor Surg 2003;2:682-684.
• Gebitekin C, Bayram AS, Akın S. Complex pulmonary as- pergilloma treated with single stage cavernostomy and myoplasty. Eur J Cardio-thor Surg 2005;27:737-740.
• Miller JI Jr. Postsurgical Empyema. In: Shields TW, ed. Gen- eral Thoracic Surgery. Philadelphia: Wolters Kluwery/Lip- pincott Williams and Wilkins. 2009:785.