Surgical Treatment in Bronchiectasis: Results of 191 Patients

Abstract

Objectives: To investigate the long-term follow-up results of the patients who underwent surgery with bronchiectasis and whether there is a difference in clinical results compared to complete or incomplete resection. Materials and Methods: A total of 191 patients who underwent surgery with the diagnosis of bronchiectasis were enrolled in Ankara University Faculty of Medicine Department of Thoracic Surgery between 1990 and 2002. The age and the gender of the patients, preoperative symptoms, localization of disease, resection indications, type of resection, complications encountered in the postoperative period, operative mortality and the association between complete/incomplete resection and postoperative symptoms were evaluated, retrospectively. Results: The indications for surgery were failure of medical therapy in 181 patients (94.8%), massive hemoptysis in five (2.6%), lung abscess in three (1.6%) and bronchiectasis due to foreign body aspiration in two (1%). In the postoperative period, 173 patients could be followed up clinically and radiologically with an average of 4.6 years (1 month to 10 years). When complete resection and incomplete resection results were compared, of the 155 patients who underwent complete resection, 135 (87.1%) were asymptomatic, 18 (11.6%) had a significant regression, and two (1.3%) had no change of preoperative symptoms, of the 18 patients who underwent incomplete resection, 14 (77.8%) had a significant regression, while 4 (22.2%) had no change of preoperative symptoms. The results of complete resection were significantly better than those of incomplete resection (p<0.05). Conclusion: Symptomatic localized bronchiectasis cases are the most appropriate candidates for surgical treatment. Resection should be complete. Incomplete resection is the most important determinant in the continuation of symptoms after surgical treatment.

Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases

“…However, in cases where medical treatment is insufficient or situations such as hemoptysis that threaten life, palliative surgery should be considered. 3 Bilateral bronchiectasis is not a contraindication for surgery. This is because even partial resection may provide considerable benefits to patients.…”

“…Surgical treatment is preferred only in cases that have unique symptoms such as hemoptysis, which is resistant to treatment or on which treatment is insufficient, or recurring episodes of pneumonia. 2,3 Different publications reported the rates of mortality in surgical treatment to be in the range of 0-3.4%. 4,5 There is little information on long-term outcomes after surgery.…”