Aspergilloma 감염에 의한 객혈
훈남의대생
조회 532
26.01.13
안녕하세요. 수술 적응증에 Aspergilloma가 있는데, 혹시 그럼 감염이 확인 되면 BAE 없이 바로 수술로 들어가는걸까요? 감사합니다!
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chathery
26.01.14
(재발+HD stable + 정상 폐가 구별이 잘 될때) or (BAE로 객혈이 멎지 않을 때) 수술을 선택한다고 합니다.
훈남의대생
26.01.14
그럼 Aspergilloma에 의한 객혈이라고 바로 수술을 한다고 이해하면 안되겠군요!! 답변 감사드립니다!!
arktiz962
26.01.17
Massive hemoptysis due to aspergilloma is not an absolute indication for immediate surgical resection without prior bronchial artery embolization (BAE). According to the American College of Radiology, BAE is the first-line therapy for massive hemoptysis, including cases caused by aspergilloma, and surgery is recommended as definitive treatment only after initial intervention with BAE for acute massive hemoptysis. The rationale is that BAE can achieve immediate control of bleeding in a significant proportion of patients, but in the subset with aspergilloma, the immediate success rate is lower (64%) and recurrence is higher (55%), so surgery is advised after BAE rather than as the initial intervention.
arktiz962
26.01.17
Therefore, the presence of aspergilloma alone does not mandate immediate surgery; surgery should be considered if BAE fails or if there is recurrent hemoptysis after BAE. This approach aligns with the general indications for surgical resection in massive hemoptysis: failure of previous treatments (including BAE) and recurrent hemoptysis. The American College of Radiology justifies this recommendation by citing the lower efficacy and higher recurrence rates of BAE in aspergilloma, but still recommends attempting BAE first before proceeding to surgery.
arktiz962
26.01.17
"Aspergilloma 에 의한 대량객혈" 이라고 써놓은 거 빼고 외우면 되겠네요
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