Surgical Treatment Of Bronchiectasis Research Articles

Video-assisted thoracoscopic surgery for non-cystic fibrosis bronchiectasis in children.

Pediatric bronchiectasis is a common respiratory disease in children. The use of video-assisted thoracoscopic surgery (VATS) for its treatment remains controversial. The objective of our study was to compare and analyze the clinical efficacy of thoracoscopic surgery and thoracotomy in the treatment of pediatric bronchiectasis and summarize the surgical treatment experience of VATS in children with bronchiectasis. Retrospective single-center cohort study. A retrospective analysis was conducted on the clinical data of 46 pediatric patients who underwent surgery with bronchiectasis at the Children's Hospital of Chongqing Medical University from May 2015 to May 2023. The patients were divided into two groups: the VATS group (25 cases) and the thoracotomy group (21 cases). Comparative analysis was performed on various parameters including basic clinical data, surgical methods, operation time, intraoperative blood loss, transfusion status, postoperative pain, postoperative mechanical ventilation time, chest tube drainage time, length of hospital stay, incidence of complications, and follow-up information. There were no statistically significant differences between the two groups of patients in terms of age, weight, gender, etiology, duration of symptoms, site of onset, and comorbidities (p > 0.05). The operation time in the VATS group was longer than that in the thoracotomy group (p < 0.001). However, the VATS group had better outcomes in terms of intraoperative blood loss, transfusion status, postoperative pain, postoperative mechanical ventilation time, chest tube drainage time, and length of hospital stay (p < 0.05). The incidence of postoperative complications in the VATS group was lower than that in the thoracotomy group, although the difference was not statistically significant (p = 0.152). Follow-up data showed no statistically significant difference in the surgical treatment outcomes between the two groups (p = 0.493). The incidence of complications and mortality in surgical treatment of bronchiectasis is acceptable. Compared with thoracotomy surgery, VATS has advantages such as smaller trauma, less pain, faster recovery, and fewer complications. For suitable pediatric patients with bronchiectasis, VATS is a safe and effective surgical method.

Bilateral staged anatomic lung resection for bronchiectasis and infected polycystic disease complicated by bleeding: viability with 3 hypertrophied segments maintained

Bilateral lung resections are performed for various pathologies: pulmonary emphysema, parasitic diseases, metastatic lesions, and bronchiectasis. In clinical practice, sequential or staged interventions are more common. Surgical treatment of bronchiectasis is currently carried out only in cases with complications of localized forms and, as a rule, consists of resection of the affected part of the lung. The percentage of such patients is not large and amounts to about 5%. Taking into account the chronic course of bronchiectasis and certain successes of the conservative treatment, indications for resection operations may arise at different periods of the patient’s life. Sometimes, up to several decades can pass between the surgeries. Aim. To demonstrate a rare clinical case of staged lung resection for bronchiectasis in a patient who had 4 lung lobes removed with an interval of 52 years. Results. History of the disease was described. Indications for staged surgical interventions were identified. The main characteristics of the health status after the surgeries were described. Conclusion. The presented case illustrates the place and role of surgical methods in the treatment of bronchiectasis, as well as the compensatory capabilities of the lung tissue in the case of staged resection interventions.

Surgical treatment of bronchiectasis in children: An 11-year experience at a central health facility in KwaZulu-Natal, South Africa

&#x0D; &#x0D; &#x0D; &#x0D; Background. The surgical management of children with bronchiectasis has seldom been reported.Objective. To describe the presentation, surgical management and outcomes in children with bronchiectasis presenting for surgery. Methods. We retrospectively reviewed the electronic records of 0 - 13-year-old children who underwent pulmonary resection for bronchiectasis at Inkosi Albert Luthuli Central Hospital, Durban, South Africa, between January 2004 and December 2014. Clinical, radiological and preoperative bronchoscopic findings, as well as surgical and histological outcomes, were analysed.Results. Eighty-eight patients underwent surgical resection. The female/male ratio was 3:2, with a mean age at surgery of 8.2 (range 2 - 13) years; 39 patients were HIV infected and 39 were HIV uninfected. Tuberculosis (TB) (n=68; 77.2%) was the most common cause of bronchiectasis, and recurrent chest infection (n= 45; 51.1%) was the most common clinical finding. Radiological examination confirmed isolated left-sided disease in 40 children (45.4%), isolated right-sided disease in 28 (31.8%) and bilateral disease in 20 (22.7%). Saccular disease with fibrocavitation (n=35; 39.7%) was the most common morphological disease type. Preoperative bronchoalveolar lavage samples confirmed a bacterial cause in 27 patients (30.6%). The most common operative procedures were primary pneumonectomy in 33 patients (37.0%), lobectomy in 30 (34.0%) and bilobectomy in 13 (14.7%). Seventy-five patients were asymptomatic after the operation and complications occurred in 13. Two children (2.2%), one with sepsis and the other with intraoperative hypoxia, died. Seventy patients underwent complete resection. At 1 month after surgery, 89.2% of patients were asymptomatic, while 77.7% of symptomatic patients were HIV positive.Conclusions. Complete pulmonary resection in children with advanced-stage bronchiectasis is safe, with a low morbidity and mortality. Surgery in HIV-positive patients was not associated with worse outcomes and is not contraindicated. HIV- and TB-preventive measures could reduce the burden of childhood bronchiectasis.&#x0D; &#x0D; &#x0D; &#x0D;

Treatment of Bronchiectasis in the Era of Minimally Invasive Surgery: 10-Year Experience in a Single Center

Bronchiectasis is a chronic pulmonary disease characterized by permanent enlargement of the bronchi and bronchioles. Anatomic resection of the affected lung part is still the most valid treatment option in localized disease. Despite the promising results of video-assisted thoracoscopic surgery (VATS) in patients with early-stage lung cancer, VATS is still controversial in bronchiectasis. In this study, we aim to present our surgical experience in patients with bronchiectasis by comparing the results of VATS and thoracotomy groups. We reviewed the medical records of patients who underwent anatomic lung resection via VATS and thoracotomy for the treatment of bronchiectasis between January 2009 and December 2019. Between January 2009 and December 2019, 50 patients with bronchiectasis were surgically treated in our department. Among them, 20 patients underwent attempted VATS lung resection, and 30 patients underwent thoracotomy. There was no difference in the intraoperative and postoperative complications, but postoperative pain scores were lower in the VATS group. Video-assisted thoracoscopic surgery is a safe and feasible technique in the surgical treatment of bronchiectasis.

Surgical treatment of bronchiectasis: Our 23 years of experience.

Background In this study, we aimed to evaluate the success of surgery and a complete resection for bronchiectasis treatment and to present our 23 years of surgical experience. Methods Between January 1991 and December 2013, a total of 1,357 patients (667 males, 690 females; mean age 30.5±14.3 years; range, 3 to 73 years) with the diagnosis of bronchiectasis who underwent pulmonary resection in our clinic were retrospectively analyzed. Demographic and clinical characteristics of the patients, etiologies, symptoms, localizations, surgical procedures, and long-term follow-up results were evaluated. Results There were 1,394 surgeries, as 37 (2.7%) patients had bilateral disease. The surgical procedures included lobectomy (n=702, 50.3%), pneumonectomy (n=183, 13.1%), segmental resections (n=114, 8.2%), bilobectomy (n=83, 6.0%), and lobectomy + segmentectomy (n=312, 22.4%). During the postoperative period, 1,269 (93.5%) patients were followed at a mean duration of 51.6 (range, 1 to 120) months. After surgery, 774 (61%) patients were asymptomatic, 456 (35.9%) showed an improvement, and 39 (3.1%) had no response or deterioration. Conclusion The surgical treatment plays an important role in the clinical and symptomatic improvement of patients with bronchiectasis. Surgery reduces the morbidity and mortality rates with careful preoperative preparation and appropriately selected cases.

Surgical Treatment in Bronchiectasis: Results of 191 Patients

Surgical Treatment in Bronchiectasis: Results of 191 Patients

Surgical Treatment in Bronchiectasis: Analysis of Our Patients.

Background: Bronchiectasis is usually caused by pulmonary infections and bronchial obstructions. It is still a serious problem in developing countries, as our country. We reviewed the morbidity and mortal-ity rates and outcomes of bronchiectasis surgical treatment.&#x0D; Patients and methods: Between years 2000 and 2016, one hundred and seven (107) patients, sixty nine (69) of whom female and thirty eight (38) male underwent pulmonary resection for bronchiecta-sis. The mean age was 35years (range, 13–66 years). Mean duration of symptoms was 12 years.&#x0D; Results: Symptoms were copious amount of purulent sputum in 84 patients, expectoration of foul-smelling sputum in 72, haemoptysis in 21 and cough in all patients. The indications for pulmonary resection were: medical therapy failure in eighty two (82) patients, massive haemoptysis in eighteen&#x0D; and lung abscess in seven (7) patients. The disease was bilateral in twenty seven (27) patients and mainly confined in the lower lobe. Eighty six (86) patients had a lobectomy, 7 had a segmentectomy, two patients right pneumonectomy. Operative morbidity was seen in 47 patients (43.9 %) and mor-tality in two (2) patients. Follow-up was complete in 97 patients with a mean of 5 years. Overall, 78 patients were asymptomatic after surgical treatment; symptoms were improved in 24, and unchanged or worse in 5.&#x0D; Conclusions: Surgical treatment of bronchiectasis is more effective in patient with localized disease. It is satisfactory with acceptable ratio of morbidity and mortality.

Surgical treatment of bronchiectasis: A review of 20 years of experience

BackgroundBronchiectasis is defined as an abnormal and irreversible dilation and distortion of the bronchi, which has numerous causes. Surgical treatment of this disease is usually reserved for focal disease and when the medical treatment is no longer effective. We report our center experience and outcomes in bronchiectasis surgery during the last 20 years. MethodsBetween 1994 and 2014, sixty-nine patients underwent surgical resection for bronchiectasis. Patient demographics, presenting symptoms, indications for surgical treatment, type of lung resection, morbidity and mortality, as well as clinical follow-up and outcomes were analyzed. ResultsFrom the 69 patients included, 31 (44.9%) were male and 38 (55.1%) were female. Surgery was indicated because of unsuccessful medical therapy in 33 patients (47.8%), haemoptysis in 22 patients (31.9%), nondiagnostic lung mass in 9 patients (13.0%) and lung abscess in 5 patients (7.3%). The surgical procedures were lobectomy in 45 (65.2%) patients, pneumonectomy in 10 (14.5%) patients, bilobectomy in 8 (11.6%) patients, lobectomy plus segmentectomy in 3 (4.3%) patients and only segmentectomy in 3 (4.3%) patients. Morbidity rate was 14.5% and there was no perioperative mortality. The follow-up was possible in 60 patients, with an outcome reported as excellent in 44 (73.3%) patients, as improved in 11 (18.3%) and as unchanged in 5 (8.3%). ConclusionAlthough the number of patients with bronchiectasis referred for surgical treatment has decreased, pulmonary resection still plays a significant role. Surgical resection of localized bronchiectasis is a safe procedure with proven improvement of quality of life for the majority of patients.

Surgical treatment of bronchiectasis: A retrospective observational study of 260 patients

Objective: This study aims to demonstrate our surgical experience for bronchiectasis and analyze the risk factors related with the surgery outcome. Methods: We retrospectively reviewed medical records of 260 consecutive patients who underwent surgery for bronchiectasis between January 2000 and December 2010. The factors related with the outcome were analyzed and the candidate factors were screened by χ2 test and t test. Furthermore, logistic regression analysis was used for multiple factor analysis to obtain the independent factors that affected the surgical outcome. Results: Complications occurred in 30 (11.5%) patients during perioperative period. The univariate analysis showed that significant differences can be observed in age (P = 0.000), sputum volume (P = 0.000), smoking history (P = 0.033), pulmonary function (P = 0.003), Gram-negative bacillus infection (P = 0.000), bronchial stump coverage (P = 0.016) using intercostals muscles or pedicle pleura embedding and surgical approach (P = 0.003) between the patients with excellent and poor outcome. The multivariable analyses showed that sputum volume (P = 0.000), Gram-negative bacillus infection (P = 0.000) and bronchial stump coverage (P = 0.000) were the three independent factors related with surgical outcome. Conclusion: Surgery is an effective treatment option for bronchiectasis. Sputum volumes lower than 30 mL, negative proof of Gram-negative bacteria and bronchial stump coverage using intercostals muscles or pedicle pleura embedding are the key factors for successful treatment. Special attention has to be given to any complications in elderly patients.

Surgical treatment of bronchiectasis: clinical characteristics and long-term outcomes

Surgical treatment of bronchiectasis: clinical characteristics and long-term outcomes

Surgical outcome of bronchiectasis in children: long term results of 60 cases.

Bronchiectasis is described as destruction and the irreversible dilatation of bronchial structure. We wanted to demonstrate our surgical practice and outcome of surgical treatment in bronchiectasis. We studied records of 60 pediatric patients who underwent surgical resection in our clinic between January 2000 and January 2013. The results were analyzed regarding factors influencing the outcome. There were 32 boys and 28 girls with a mean age of 9.45 years (range 2-15). The most common cause was childhood infection in 25 (41.66%). The mean duration of the symptoms was 42.93 months. Patients underwent 64 operations including 2 staged thoracotomies and 2 re-thoracotomies. Atelectasis was the most frequent complication. Longer duration of symptoms related to postoperative complication. The morbidity and mortality rates were 20% and 3.33%, respectively. The outcome was optimal in 92%. Forced expiratory volume in 1 s less than 60% of the predicted value, hemoptysis and duration of symptoms were found prognostic variables for postoperative morbidity with high ratios of odds coefficients by using Binary Logistic Regression Method. Complete and early resection of bronchiectasis provides a successful outcome. Duration of symptoms and timely intervention have a major impact on the management and prognosis.

Surgical treatment of bronchiectasis: a retrospective observational study of 138 patients.

We analyzed cases of bronchiectasis; its presentation, etiology, diagnosis, indications for surgery, surgical approach, and the outcome. A retrospective analysis of 138 patients who underwent surgery for bronchiectasis. The mean age was 30.2±15.7 years. 55.8% patients were males. Symptoms were recurrent infection with cough in all patients, fetid sputum (79.7%), and hemoptysis (22.5%). The etiology was recurrent childhood infection (38.4%), pneumonia (29%), TB (9.4%), sequestration (4.3%), foreign body obstruction (4.3%), and unknown etiology (14.5%). CXR, CT scan, and bronchoscope were done for all patients. Bronchiectasis was left-sided in (55.1%) of patients. It was mainly confined to the lower lobes either alone (50.7%) or in conjunction with middle lobe or lingual (7.2%). Indications for resection were failure of conservative therapy (71.7%), hemoptysis (15.9%), destroyed lung (8%), and sequestration (4.3%). Surgery was lobectomy (81.2%), bilobectomy (8.7%), and pneumonectomy (8%). Complications occurred in 13% with no operative mortality. 84% of patients had relief of their preoperative symptoms. Surgery for bronchiectasis can be performed with acceptable morbidity and mortality at any age for localized disease. Proper selection and preparation of the patients and complete resection of the involved sites are required for the optimum control of symptoms and better outcomes.

The Influence of Specific Factors on Postoperative Morbidity in Young Adults with Bronchiectasis

Surgical treatment of bronchiectasis is associated with acceptable mortality and morbidity rates. To date, few reports on the prediction of postoperative morbidity using some preoperative measures have been presented. We present our results regarding the influence of some specific factors on postoperative morbidity on young adult patients who were treated surgically for bronchiectasis. Between January 2000 and July 2007, 122 patients were operated upon. Female gender, increased number of resected segments, presence of haemoptysis and bilateral disease, compromised pulmonary function test (FEV1/VC<60%) and absence of preoperative fiberoptic bronchoscopy (FOB) were examined as the potential risk factors for postoperative complications such as persistent air leak (PAL), atelectasis, residual air space (RAS), bronchopleural fistula (BPF) and empyaema. There was no operative mortality. Morbidity was observed in a total of 16 patients with an overall morbidity rate of 13.1%. Complete resection was achieved in 88 patients (72.1%). The number of resected segments was not found to be significantly associated with increased morbidity. Presence of preoperative haemoptysis did not correlate with postoperative complications significantly. Absence of preoperative FOB was not found to be associated with post-operative complications (p<0.05). Compromised PFT was significantly associated with RAS (p=0.028), however it was not associated with increased risk of PAL, atelectasis or empyaema significantly. Multi-segmental resectable bronchiectasis should not be considered an occult risk factor for morbidity after resection. Associated non-severe haemoptysis and absence of preoperative bronchoscopy are not associated with significant increased risk of postoperative morbidity.

Clinical research on conservative treatment and surgical treatment for bronchiectasis

Objective To compare the curative effect of conservative treatment and surgical treatment for bronchiectasis. Methods 60 patients with bronchiectasis were randomly divided into observation group and control group,30 cases in each group,they were treated with surgery and medical therapy respectively,the clinical efficacy,length of stay, costs, remission time of symptoms and signs, changes of blood gas index and ESR, CRP,TNF-α, WBC,NEUT of the two groups after treatment were compared. Results The curative rate of observation group was significandy higher than control group, while the length of stay, remission time of symptoms and signs and hospitalization costs were significantly lower than control group, the difference was statistically significant (all P ＜0.05) ;After treatmenit,the blood gas index of both groups improved significantly than before treatment(all P ＜ 0.05), and the blood gas index of observation group improved significantly than the control group (all P ＜ 0. 05); After treatment, ESR, CRP,TNF-α,WBC and NEUT of both groups were significantly decreased compared with those before treatment(all P ＜0. 05); Between the two groups, the index value of the observation group decreased significantly (all P ＜ 0.05).Conclusion Surgical treatment for bronchiectasis was superior to conservative treatment with better curative effect,lower cost, shorter hospital stay and faster relief of symptoms and signs, it had good prospects to be applied. Key words: Bronchiectasis; Polypharmacy; Thoracic surgical procedures; Treatment outcome

Surgical Treatment of Bronchiectasis: A Retrospective Analysis of 790 Patients

The global incidence of bronchiectasis is increasing, and this disease is prevalent in rural China. This study examined operative mortality, morbidity, and outcomes of surgery for bronchiectasis at a single institution in China. We retrospectively reviewed the medical records of 790 consecutive patients who underwent surgery for bronchiectasis in our department between January 1989 and December 2008. Localized bronchiectasis was diagnosed by high-resolution computed tomography. The persistence of symptoms after failure of nonsurgical treatment was an indication for surgery. Cystic fibrosis patients were excluded from this study. The study sample included 790 patients (466 male, 324 female) who underwent 810 operations for bronchiectasis. Mean age at time of surgery was 41.6 years (range, 6 to 79 years). Several surgical procedures were used: lobectomy (497; 62.9%), segment resection (37; 4.7%), pneumonectomy (90; 11.3%), bilobectomy (56; 7.1%), and lobectomy and segmentectomy (110; 14.0%). There were no intraoperative deaths. Nine (1.1%) patients died in the postoperative period. Univariate analysis showed that advanced age (p = 0.04) and renal failure (p = 0.001) were associated with postoperative mortality, and multivariate analysis revealed that preoperative renal failure was associated with mortality (p = 0.025). The mean follow-up time was 4.2 years (range, 10 months to 10 years). After surgery, 478 (60.5%) patients were asymptomatic, 111 (14.1%) had improved, and 117 (14.8%) showed no improvement or worsened condition. Localized bronchiectasis is usually the indication for surgical resection, which is a safe procedure with acceptable operative morbidity, mortality, and outcomes.

Surgical treatment of bronchiectasis

While the prevalence of bronchiectasis has decreased significantly over recent decades in developed countries, resection for bronchiectasis still plays an important part in thoracic surgery practice in some countries, such as Portugal. Between 1994 and 2004, 51 patients (29 female and 22 male) with a mean age of 38.6 years (range 4–65 years) underwent pulmonary resection for bronchiectasis. Mean duration of symptoms was 4.8 years. Surgery was indicated because of unsuccessful medical therapy in 25 patients (49.1%), haemoptysis in 12 (23.5%), lung mass in 9 (17.6%) and lung abscess in 5 (9.8%). The surgical treatment was pulmonectomy in 7 patients, bilobectomy in 3, lobectomy in 36 and segmentectomy in 5. There was no operative mortality. Complications occurred in 8 patients and the morbidity rate was 15.7%. Follow-up was complete in 45 (88.2%) patients with a mean of 3.4 years. Overall, 35 (77.7%) patients were asymptomatic after surgery, symptoms were improved in 7 (15.6%), and unchanged or worse in 3 (6.7%). Unsuccessful medical therapy was still our main indication for surgery of bronchiectasis, despite aggressive antibiotic therapy. Surgical resection was performed with acceptable morbidity and morbidity and markedly improved symptoms in the majority of patients.

Surgical treatment of bronchiectasis: a collective review of 487 cases.

Pulmonary resection to treat bronchiectasis in a total of 487 patients between December 1976 through June 1988 is reported on. The surgical treatment consisted of pneumonectomy in 190 cases (144 left and 46 right), lobectomy in 202 cases, bilobectomy in 23 cases and lobectomy combined with segmental resection in 72 cases. The overall mortality rate was 3.5%. Patients were followed up for a period ranging between 4 months to 10 years: at the end of the study 71% of the patients were completely asymptomatic. It is concluded that though the first choice of therapy must be conservative, in those patients with bronchiectasis in whom disease progresses despite medical treatment and in those whose disease requires frequent hospitalization, continuing medical treatment is unwarranted and surgery must be the choice of therapy.

Surgical treatment of bronchiectasis in childhood: O. Zamir, O.Z. Lernau, C. Springer, et al. Harefuah 110:375–377, (April 15), 1986

Surgical treatment of bronchiectasis in childhood: O. Zamir, O.Z. Lernau, C. Springer, et al. Harefuah 110:375–377, (April 15), 1986

Surgical treatment of bronchiectasis: ten-year survey.

Surgical treatment of bronchiectasis: ten-year survey.

THE SURGICAL TREATMENT OF BRONCHIECTASIS

Medical Journal of AustraliaVolume 2, Issue 9 p. 351-352 Comment and Abstract THE SURGICAL TREATMENT OF BRONCHIECTASIS First published: 01 September 1962 https://doi.org/10.5694/j.1326-5377.1962.tb20290.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue9September 1962Pages 351-352 RelatedInformation