Surgery for predominant lesion in nonlocalized bronchiectasis

Abstract

Lobectomy for the predominant lesion is a safe procedure in the surgical treatment of nonlocalized bronchiectasis and leads to significant relief of symptoms with good rates of satisfaction.

Surgical Management of Bronchiectasis

“…Preoperative removal of the secretions and clearing of the airways is an important indication of bronchoscopy in adult and children patients [63], as it is associated with lower rate of postoperative complications [41].…”

“…The patients should have appropriate preoperative preparation until the sputum volume reduced to 20-50 mL per day [54,63], or the antibiotic therapy is modified according to new culture sensitivity results of the sputum [63]. As the gramnegative bacterial infection has a significant risk for perioperative complications, surgery should be performed after negative proof of Gram-negative bacillus on sputum culture analysis [58].…”

“…Extrapleural dissection is preferred to avoid spillage of lung content into pleural space. After identification of the hilar structures and opening of the major fissure, arterial, venous, and bronchial branches are isolated and divided, respectively [39,63].…”

“…Also, the evidence of pleural infection indicates pleural space irrigation with antibiotic [73]. Following placement of the chest drains, bronchoscopic evaluation of the bronchial sutures with removal of any secretions in the airway should be performed [63]. The resected specimens should be sent for histopathological examination [41].…”

Medical management of bronchiectasis

“…Surgical resection is a viable option for some patients with bronchiectasis, either to remove the most involved part of the lung or a focal area of disease. Case series have demonstrated the safety of this approach in experienced centers (47,48) and the surgical approach is discussed elsewhere in this volume.…”