Aspergillome der Lunge – Indikationen zur Operation und chirurgische Techniken

Zusammenfassung

Aspergillen können präformierte Höhlen in der Lunge infizieren und ursächlich für die Ausbildung eines Aspergilloms sein. Lebensbedrohliche Hämoptysen können die Folge sein. Das Ziel dieser Übersichtsarbeit ist es, aktuelle Behandlungsstrategien von Aspergillomen zusammenzufassen. Symptomatische Aspergillome sollten einer chirurgischen Therapie zugeführt werden. Dabei ist die Lobektomie die Therapie der Wahl. Ein minimalinvasives Vorgehen kann bei selektionierten Patienten gerechtfertigt sein. Die Rolle der perioperativen antifungalen Therapie bei immunkompetenten Patienten wird kontrovers diskutiert. Die antimykotische Therapie und Embolisation der Bronchialarterien können Therapieoptionen bei inoperablen Patienten sein.

Abstract

Aspergillus species may infect preexisting lung cavities and cause pulmonary aspergillomas, which may lead to life-threatening haemoptysis. The objective of this review article is to summarise current strategies for the management of pulmonary aspergillomas. Symptomatic aspergillomas should be treated surgically, with lobectomy being the treatment of choice. Minimally-invasive approaches may be appropriate in selected cases. The role of perioperative antifungal therapy in immunocompetent patients remains controversial. Antimycotic treatment and embolisation of bronchial arteries may be useful treatment options for inoperable patients.

Schlüsselwörter

Aspergillom - Infektion - chirurgische Therapie - antimykotische Therapie - Hämoptysen

Key words

aspergilloma - infection - surgical therapy - antimycotic treatment - haemoptysis

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