Surgery for localized pulmonary mycotic infections in patients with hematopoietic disorder

Background: Surgical resection is considered to be the most effective treatment for localized pulmonary mycotic infections. However it is also a particularly challenging procedure because it is associated with considerable mortality and morbidity. Furthermore, hematopoietic disorders usually cause immunosuppression, anemia, and coagulopathy, which are definite risk factors for surgery. The purpose of this study is to evaluate the surgical outcomes of pulmonary mycotic infections in hematopoietic disorder patients. Methods: Between 2011 and 2013, 23 patients underwent surgical treatment for pulmonary mycotic infections at a single institution. The patients were divided into two groups; Group A (hematopoietic disorder patients, n=9) and Group B (n=14). We retrospectively reviewed medical and radiologic data. Results: The complex type was more frequent in group A (66.6%) than in group B (35.7%). Postoperatively, there was no mortality. However, morbidity was 22.2% (2 incomplete expansion) in group A, and 35.6% (1 prolonged air leak, 3 bleeding, 1 Bronchopleural fistula) in group B. The difference in morbidity between the groups did not show any statistical significance (p=0.657) as well as duration of chest tube drainage, and postoperative hospital stay. The hematopoietic disorder patients did not impose a risk factor for morbidity and mortality. Conclusions: Although hematopoietic disorder patients have many surgical risk factors, the surgical treatment of pulmonary mycotic infections produces very acceptable outcomes in selected cases.