Surgical Resection For Bronchiectasis Research Articles

To Compare the Outcome of Surgical Resection for Bronchiectasis With and Without Intercostal Muscle Flap: 15-Year Peshawar Experience

To Compare the Outcome of Surgical Resection for Bronchiectasis With and Without Intercostal Muscle Flap: 15-Year Peshawar Experience

Surgical management of bronchiectasis

Background: Bronchiectasis is the permanent dilatation of the bronchi due to destruction of bronchial wall. Bronchi­ectasis still remains a serious problem in developing countries despite of modern medical facilities.Objectives: This study aims to demonstrate our surgical experience for bronchiectasis and analyze the risk factors related with the surgery outcome.Methods: Hospital based analyses of 39 patients were done who were underwent surgery for bronchiectasis and were on follow up in National Institute of Diseases of Chest hospital (NIDCH) in September 2014 to February 2015 were included in this study. All 39 patients had surgery for the bronchiectasis in the period of January 2014 to December 2014.Results: The mean age of the patients were 22.2 years. Twenty four patients were females and 15 were male. Symptoms were recurrent infection with cough, copious sputum in all patients and hemoptysis in 31 patients. The etiology was recur­rent childhood infection in 17 patients, pneumonia in 11 patients, PTB in 6 patients, Aspiration in 2 patients, foreign body obstruction in 1 patient, and unknown etiology in 2 patients. Chest x-ray, CT scan and rigid bronchoscope were done for all patients. Bronchiectasis was left-sided in 17 patients. It was mainly confined to the lower lobes either alone in 9 patients and in conjunction with middle lobe or lingual in 8 patients. Indications for resection were failure of conservative therapy in 22 patients, hemoptysis in 8 patients, destroyed lung in 9 patients. Surgery was lobectomy in 24 patients, Bilobectomy in 5 patients, and pneumonectomy in 10 patients. Complications occurred in 10 patients with no operative mortality. Thirty four patients had relief of their preoperative symptoms after surgery in follow up periods.Conclusions: Surgical resection for bronchiectasis should be reserved for patients with localised disease who have failed medical management and have persistent symptoms that negatively affect their quality of life.

Surgical management of bronchiectasis: a 5-year review of a single center’s experience

Bronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study is to present our experience in surgical treatment of patients with bronchiectasis during a 5-year period and their early- and late-term results. Records of 48 patients who underwent surgical resection for bronchiectasis from April 2009 through March 2014 at Cardiothoracic Surgery Department of Gauhati Medical College Hospital were reviewed. Variables analyzed were age, sex, symptoms, etiology, extent, indication and type of operation, mortality, morbidity, and the result of surgical therapy. There were 42 (87.5 %) male and 6 (12.5 %) female patients with an average age of 33.7 years (range, 19–47 years). The indications for surgery were failure of conservative treatment in 21 patients (43.75 %), recurrent hemoptysis in 20 (41.66 %), destroyed lung in 5 (10.42 %), and endobronchial obstruction in 2 (4.17 %). Thirty-four patients (70.83 %) had complete resection with lobectomy, pneumonectomy, or bilateral lobectomy, and 14 (29.17 %) had incomplete resection with segmentectomy or lobectomy with segmentectomy. There were no perioperative deaths; complications occurred in 10 patients with a morbidity rate of 20.83 %. Follow-up data were obtained for 44 (91.66 %) of the patients for a mean of 9 months (range, 4 months to 3.5 years). The symptoms disappeared in 21 patients (47.43 %) and improved in 17 (38.64 %). Improvement of symptoms was observed more significantly in the patients undergoing complete resection. Surgical resection for bronchiectasis obtains satisfactory long-term results with acceptable morbidity and mortality rates. When possible, complete resection should be performed.

Surgical resection is an effective treatment of bronchiectasis in selected patients.

In this issue of Journal of Thoracic Disease Al-Refaie et al . report their retrospective observational series on 138 patients operated for bronchiectasis (BE) in a single tertiary referral hospital in Egypt (1). The authors report no operative mortality and a complication rate of only 13%. Although similar results have been presented earlier (2,3), the authors should be congratulated for their excellent outcome in this often difficult group of patients. Furthermore, their study brings an important message that surgical resection for BE can be performed with low morbidity and mortality, especially in this part of the world where pulmonary infections with serious sequale are common.

Surgical treatment of bronchiectasis in children.

A previous study 1 summarized the over-all results in a series of 221 patients of all ages who underwent surgical resection for bronchiectasis. The present study represents an evaluation of the 30 children, ranging in age from 5 to 14 years, included in that series. Fourteen of the patients were boys, and 16 were girls. Pulmonary resection was carried out in all instances, with the patient under general endotracheal anesthesia; a posterolateral incision was used, with individual ligation of hilar structures. All patients were operated on prior to December, 1952, and all were followed by direct observation of the child and by follow-up letter. Preoperative bronchoscopy was done in all cases, as were bronchograms. Pathological examination confirmed the clinical impression in all cases. CLINICAL RESULTS The clinical results in this series of 30 cases were good in 18 (60% ), fair in 7 (23.3%), and poor in 4 (13.3%). No operative