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Ann Thorac Surg 2004;78:1846-1848
© 2004 The Society of Thoracic Surgeons

Case report

Cavernoscopic Removal of a Fungus Ball for Pulmonary Complex Aspergilloma

Motoyasu Sagawa, MD*,a, Tsutomu Sakuma, MDa, Tsugimasa Isobe, MDb, Makoto Sugita, MDa, Yuko Waseda, MDc, Hideo Morinaga, MDb, Keiji Iuchi, MDd

a Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
b Department of Surgery, Tatsunokuchi Houju Memorial General Hospital, Japan
c Department of Internal Medicine, Tatsunokuchi Houju Memorial General Hospital, Tatsunokuchi, Ishikawa, Japan
d Department of Surgery, National Kinki Chuo Hospital, Sakai, Osaka, Japan

Accepted for publication July 17, 2003.

* Address reprint requests to Dr Sagawa, Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
sagawam{at}kanazawa-med.ac.jp

Lobectomy of the lung for aspergilloma is not always appropriate in elderly patients because of the high surgical risk. A 78-year-old male diagnosed with complex aspergilloma was referred to our hospital for recurrent hemoptysis. Because he refused lobectomy, we conducted a cavernoscopic removal of the fungus ball. The site of the skin incision was carefully designed preoperatively. After achieving access, the fungus ball was removed piece by piece under endoscopic view. Intraoperative blood loss equaled 30 mL. At 5 months postoperative follow-up, the patient had no evidence of recurrence. This procedure may be useful in some patients with complex aspergilloma.






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