A long-term study assessing the factors influencing survival and morbidity in the surgical management of bronchiectasis

Abstract

BackgroundAlthough the prevalence of bronchiectasis decreased significantly in developed countries, in less developed and in developing countries, it still represents a significant cause of morbidity and mortality. The aim of this retrospective study is to present our surgical experiences, the morbidity and mortality rates and outcome of surgical treatment for bronchiectasis.MethodsWe reviewed the medical records of 129 patients who underwent surgical resection for bronchiectasis between April 2002 and April 2010, at Van Training and Research Hospital, Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and surgical procedures, mortality, morbidity and the result of surgical therapy were analyzed retrospectively.ResultsMean age was 21.8 year (the eldest was 67 year, the youngest was 4 years-old). Male/female ratio was 1.86 and 75% of all patients were young population under the age of 40. Bilateral involvement was 14.7%, left/right side ratio according to localization was 2.1/1. The most common reason for bronchiectasis was recurrent infection. Surgical indications were as follows: recurrent infection (54%), hemoptysis (35%), empyema (6%), and lung abscess (5%). There was no operative mortality. Complications occurred in 29 patients and the morbidity rate was 22.4%. Complete resection was achieved in 110 (85.2%) patients. Follow-up data were obtained for 123 (95%) of the patients. One patient died during follow-up. The mean follow-up of this patient was 9 months. Mean postoperative hospitalization time was 9.15 ± 6.25 days. Significantly better results were obtained in patients who had undergone a complete resection.ConclusionsSurgical treatment of 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.

Efficiency and safety of surgical intervention to patients with Non-Cystic Fibrosis bronchiectasis: a meta-analysis

“…Besides medical treatment and respiratory physiotherapy, surgical treatment is an eligible therapy for patients with non-CF bronchiectasis, especially to those with little response to conservative interventions 7 . Over the years, many studies have reported surgical intervention in the management of patients with non-CF bronchiectasis 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 . The surgical procedure was aimed at primary resection of the affected area, as assessed by high-resolution computed tomographic (HRCT).…”

Surgery for predominant lesion in nonlocalized bronchiectasis

“…To note, 2 major complications, empyema and persistent air leak, occurred but A, Data from the present study; B, data from the study by Zhang and colleagues 4 ; C, data from the study by Gursoy and colleagues 15 ; and D, data from the study by Sehitogullari and colleagues. 16 both were manageable without the need for reoperation. Postoperative empyema was common in bronchiectasis, 6,16 and most could be treated successfully by tube thoracostomy.…”

“…16 both were manageable without the need for reoperation. Postoperative empyema was common in bronchiectasis, 6,16 and most could be treated successfully by tube thoracostomy. In addition, persistent air leak was frequently noted after operation, with a reported rate of 4.8% to 6.1%.…”

“…A P value less than .05 was considered statistically significant. The outcomes of patient satisfaction as to symptom relief in nonlocalized bronchiectasis were compared with those in localized bronchiectasis reported in the previous studies 4,15,16 using stacked bar graph. All statistical analyses were performed by SPSS Statistics 19 (IBM Corp, Armonk, NY).…”

“…More than 89% of patients benefited from the operation, which also was comparable with the previously reported satisfaction rates in localized bronchiectasis (Figure 3). 4,15,16 Surgery could help prevent infective exacerbations and retard disease progression before lungs become grossly diseased. 13 The 23 Localized 138 0 18 (13) Sehitogullari and colleagues (2011) 16 Localized 129 1 (0.7) 29 (22.4) Zhang and colleagues (2010) 4 Localized 790 9 (1.1) 128 (16.2) Gursoy and colleagues (2010) 15 Localized 92 1 (1) 15 (16) Eren and colleagues (2007) 13 Localized 143 2 (1.3) 33 (23.0) Schneiter and colleagues (2005) 10 Combined 48 0 6 (12.5) removal of the predominant lesion may protect the relatively less-affected bronchi from further infectious contamination and rescue the healthy segments.…”