INCIDENCE OF AIRLEAK AFTER WEDGE RESECTION VERSUS LOBECTOMY FOR PULMONARY MYCETOMA, FIVE YEARS SURGICAL EXPERIENCE IN A 3RD WORLD COUNTRY

Introduction: Pulmonary mycetoma, which usually develops from tuberculous lung pathology, is still a significant problem in the developing world. Surgical resection is inferred to be the most effective treatment technique since the use of antifungal medications alone yields poor results. Although the choice of whether to perform a wedge resection or lobectomy remains complicated by the propensity for postoperative complications such as air leaks. Objectives: To compare the incidence of postoperative air leaks in patients undergoing wedge resection versus lobectomy for pulmonary mycetoma in a tertiary care hospital in Pakistan over a five-year period. Materials and Methods: This cross-sectional study was done in the Thoracic Surgery ward of Lady Reading Hospital in Peshawar, Pakistan. The study participants were patients with confirmed pulmonary mycetoma showing complete records of undergoing a wedge resection or lobectomy between January 2018 and December 2022. These clinical variables included the incidences of air leaks, the duration of the hospital stay, and the recurrence. Results:It was observed that lobectomy patients developed less numbers of postoperative air leak and also of shorter duration as compared to those that underwent the wedge resection. The clinical characteristics found that recurrence and the length of hospital stay were much greater in the wedge resection group mainly in plans with complex mycetomas. Conclusion: Lobectomy is safer and superior in managing air leak in offering treatment to patients with complex pulmonary mycetoma than wedge resection.