Objective  To summarize the principles, techniques, and effectiveness of the surgical treatment for pulmonary aspergillosis.

  Methods  The clinical data of 34 pulmonary aspergillosis patients who had undergone surgical treatment in our department from January 1986 to December 2013 were retrospectively analyzed. Three patients with diffuse lesions manifested by CT image received wedge resection to obtain pathological tissues. Thirty-one patients with localized lesions received complete resection, in whom the surgical procedures included lobectomy (n=26), segmentectomy (n=3), and wedge resection (n=2). Thoracotomy was performed in 27 patients and video-assisted thoracoscopic surgery in 7 patients.

  Results  No perioperative death was noted. All the 34 patients were pathologically confirmed as with pulmonary aspergillosis. Five patients (14.7%) suffered from postoperative complications including pulmonary embolism (n=1), acute pulmonary edema (n=1), pleural effusion (n=1), prolonged air leak (n=1), and wound disruption (n=1). All patients were successfully discharged 2-34 days after the surgery, and the average hospital stay was (10.1±6.2) days. No relapse was noted during the 1-16 years of follow-up.

  Conclusions  For patients with suspected pulmonary aspergillosis, which may present as diffuse lung lesions, surgical biopsy provides the "golden standard" of pathological and pathogenic diagnosis. For patients with localized pulmonary aspergillosis, surgical treatment can completely remove the lesions, provide definite pathological diagnosis, and effectively relieve the symptoms.