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Plombage for Hemoptysis Control in Pulmonary Aspergilloma: Safety and Effectiveness of Forgettable Surgery in High-Risk Patients
Authors:Nguyen Truong Giang  Le Tien Dung  Nguyen Thanh Hien  Truong Thanh Thiet  Phan Sy Hiep  Dinh Cong Pho  Pham Ngoc Hung
Affiliation:Department of Cardiothoracic Surgery, Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam;Department of Thoracic Surgery, Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam;Department of Infection Control, Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam;Department of Epidemiology, Vietnam Military Medical University, Ha Noi, Vietnam;Department of Training, Vietnam Military Medical University, Ha Noi, Vietnam
Abstract:Objectives: To evaluate plombage surgery for hemoptysis control in pulmonary aspergilloma in high-risk patients.Methods: This study was carried out on 75 pulmonary aspergilloma patients presenting with hemoptysis that underwent a plombage surgery for approximately 7 years (November 2011–September 2018) at Pham Ngoc Thach Hospital. They revisited the hospital 6 months after plombage surgery and considered plombage removal. The group whose plombage was removed was compared with that whose plombage was retained 6 and 24 months after surgery.Results: Hemoptysis reduced significantly after surgery. Hemoptysis ceased in 91.67% of the patients and diminished in 8.33% of the patients 6 months after surgery. Similarly, hemoptysis ceased in 87.32% of the patients and diminished in 12.68% of the patients 24 months after surgery. Body mass index (BMI) index, Karnofsky score, and forced expiratory volume in one second (FEV1) increased. Plombage surgery was performed with operative time of 129.5 ± 36.6 min, blood loss during operation of 250.7 ± 163.1 mL, and the number of table tennis balls of 4.22 ± 2.02. No deaths related to plombage surgery were recorded. Plombage was removed in 29 cases because of patients’ requirements (89.8%), infection (6.8%), and pain (3.4%). There were no patient developing complications after the treatment and there were no statistically significant differences between the two groups.Conclusions: Plombage surgery is safe and effective for hemoptysis control in pulmonary aspergilloma. To minimize the risk of long-term complications, surgeons should remove the plombage 6 months after the initial operation.
Keywords:plombage surgery   hemoptysis control   pulmonary aspergilloma
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