Surgical management of bronchiectasis: analysis and short-term results in 238 patients

Balkanli, Kunter; Genç, Onur; Dakak, Mehmet; Gürkök, Sedat; Gözübüyük, Alper; Çaylak, Hasan; Yücel, Orhan
November 2003
European Journal of Cardio-Thoracic Surgery;Nov2003, Vol. 24 Issue 5, p699
Academic Journal
Objective: Bronchiectasis is defined permanent dilatations of bronchi with destruction of the bronchial wall. It is still a major cause of morbidity and mortality in developing countries. The aim of this retrospective study is to present our surgical experiences, the early and long-term results of 238 patients with bronchiectasis during a 10-year period. Methods: We reviewed the medical records of 238 patients who underwent surgical resection for bronchiectasis between January 1992 and December 2001, at Gu¨lhane Military Medical Academy (GMMA) Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and type of operation, mortality, morbidity and the result of surgical therapy were analyzed. Results: There were 205 (86.13%) male and 33 (13.87%) female patients with an average age of 23.7 and a range of 15–48 years. The presenting symptoms were productive cough in 133 (55.88%), fetid sputum in 116 (48.73%), recurrent infections in 84 (35.29%), and hemoptysis in 39 (12.18%) patients. The disease was bilateral in 31 patients (13.02%) and mainly confined to the lower lobes in 162 (68.06%). The surgical treatment was as follows: pneumonectomy in 13 patients (5.46%), lobectomy in 189 (79.40%), lobectomy+segmentectomy in 31 (13.02%), and wedge resection or segmentectomy in five (2.1%). Staged bilateral thoracotomy was used in 14 patients. There was no operative mortality. Complications occurred in 21 patients and the morbidity rate was 8.82%. Complete resection was achieved in 154 (64.7%) patients. Follow-up data were obtained for 229 (96.21%) of the patients. Nine patients were lost to follow-up. The mean follow-up of these patients was 9 months (range, 3 months to 4 years). The symptoms disappeared in 189 patients (79.41%) and 29 patients (12.18%) had improved, whereas 11 patients (4.62%) had no improvement. Significantly better results were obtained in patients who had undergone a complete resection. Conclusions: Surgical resection for bronchiectasis can be performed with acceptable morbidity and mortality at any age. The involved bronchiectatic sites should be resected completely for the optimum control of symptoms.


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