OBJECTIVE: to know the demographics, clinical presentation, underlying
lung disease, surgical procedure performed and its perioperative
outcome in patients with Mycetoma.
METHODOLOGY: This retrospective study was carried out in the department of thoracic surgery Lady Reading Hospital Peshawar from June 2002 to June 2013. Computerized medical records of patients operated upon for Mycetoma, were retrieved and reviewed for demographics, clinical presentation, underlying lung disease, investigations performed, operative procedure & outcome.
RESULTS: Out of 294 total patients, 176 (60%) were males and 118
(40%) females with a mean age of 38.4+11.30 years (range 14 to 71
years). Hemoptysis was present in 92% patients while Tuberculosis
was the most frequent underlying lung disease (92.5%). Lobectomy,
bi-lobectomy, wedge resection and pneumonectomy were performed
in 86.3%, 2.3%, 5.4% and 4% patients respectively. Cavernostomy was
performed in 5 patients (1.7%). Supplementary procedure (thoracoplasty
or myoplasty) was performed in 5.1% patients. The operative
time averaged 91+9.37 minutes (range 78-190 minutes). Operative
mortality was 2.3% while morbidity was 14.6% including hemorrhage
(4.4%), pleural space problems (6.4%) and others (3.7%).
CONCLUSION: Mycetoma is not uncommon in our set up and occurs
more frequently in young male patients having underlying tuberculosis.
Lobectomy was the commonest surgical procedure for Mycetoma
in our set up. Surgery can be performed safely though with increased
morbidity including hemorrhage and pleural space problems. Operative
mortality rate was 2.3%.
KEY WORDS: Mycetoma, Aspergilloma, Lobectomy, Thoracoplasty, Air
leak, Bronchopleural fistula.
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