Original Research

Operative Strategies and Long-Term Outcomes in Fungal andCavitary Lung Disease: Lessons from Two Decades of Experience

Muhammad Shoaib Nabi1
Department of Thoracic Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore
Zeeshan Sarwar1
Department of Thoracic Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore
Hassan Iftikhar1
Department of Thoracic Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore
Rafay Shamshad2
Lady Rafat Hospital, Karachi
Muhammad Saqib Musharaf3
Gulab Devi Teaching Hospital, Lahore

✉ Correspondence: Zeeshan Sarwar Email: zeeshan.sarwar195@gmail.com

DOI https://doi.org/10.70302/jpsim.v7i1.2604
Volume: 7, Issue 1 Pages: 15–21 Published: 10 Mar 2026
Received: 02 Dec 2025 Revised: 06 Feb 2026 Accepted: 16 Feb 2026 Published Online: 10 Mar 2026

Abstract

Objective

To describe patient characteristics, indications for surgery, operative techniques, perioperative outcomes, and long-term results, thereby contributing local evidence to guide future surgical management in similar high-burden settings.

Methods

This retrospective study was conducted at the Department of Thoracic Surgery, Services Hospital, Lahore, Pakistan, reviewing all patients who underwent surgery for pulmonary fungal or cavitary lung diseases between January 2005 and December 2024. Of 580 patients evaluated, 415 met the inclusion criteria for surgical intervention. Data regarding demographics, comorbidities, operative details, postoperative complications, and long-term outcomes were analyzed using SPSS version 26.

Results

Among the 415 operated patients, 271 (65.3%) were males and 144 (34.7%) females, with a mean age of 45.1 ± 13.4 years. A history of prior pulmonary tuberculosis was present in 250 patients (60.2%), hepatitis C in 183 (44%), and diabetes mellitus in 144 (34.6%). Lobectomy was the most frequently performed procedure (58.1%), followed by segmentectomy (17.3%) and cavernostomy (12.8%). The major postoperative complications included prolonged air leak (8.7%), empyema (5.3%), and bronchopleural fistula (3.4%). The overall in-hospital mortality rate was 2.4%. At follow-up, 92% of patients achieved complete cessation of hemoptysis and marked symptomatic improvement.

Conclusion

Surgical management of pulmonary fungal and cavitary lung diseases is safe and effective when performed in experienced centers. Despite technical challenges, especially in post-tuberculous lungs, operative intervention provides durable control of symptoms and excellent long-term outcomes with acceptable morbidity and mortality.

Keywords
Pulmonary aspergilloma Cavitary lung disease Fungal lung infection Thoracic surgery Lobectomy.

How to Cite This Article

Nabi MS, Sarwar Z, Iftikhar H, Shamshad R, Musharaf MS. Operative Strategies and Long-Term Outcomes in Fungal andCavitary Lung Disease: Lessons from Two Decades of Experience. J Pak Soc Intern Med. 2026;7(1):15–21. doi:10.70302/jpsim.v7i1.2604

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2026 Journal of Pakistan Society of Internal Medicine.
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