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Surgery for bronchiectasis.

D Prieto1, J Bernardo, M J Matos

  • 1Cardiothoracic Surgery, University Hospital, Coimbra, Portugal.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|June 26, 2001
PubMed
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Surgical resection for bronchiectasis offers significant symptom improvement with low complication rates. Complete disease removal enhances outcomes, while respiratory function remains stable post-surgery.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Respiratory Medicine

Background:

  • Bronchiectasis incidence has decreased in developed nations.
  • Despite medical management, some patients require surgical intervention.
  • This study evaluates surgical benefits and complications for bronchiectasis.

Purpose of the Study:

  • To clarify the benefits of surgical intervention for bronchiectasis.
  • To analyze complications associated with bronchiectasis surgery.
  • To assess the impact of complete resection on patient outcomes.

Main Methods:

  • A retrospective review of 119 patients (71 female, 48 male) who underwent surgery for bronchiectasis between 1988 and 1999.
  • Indications for surgery included failed medical therapy, hemoptysis, lung abscess, masses, and pneumothorax.

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  • Surgical procedures included lobectomy (62%), segmentectomy (10%), pneumonectomy (7.4%), and bilobectomy (3.3%), with complete resection achieved in 91% of cases.

    • Main Results:

    • No operative mortality; 15% perioperative morbidity (e.g., broncho-pleural fistulae, hemorrhage, arrhythmias).
    • At mean 4.5-year follow-up, 68% were asymptomatic, 29% improved, and 3.7% unchanged/worsened.
    • Complete resection correlated with best clinical improvement (P=0.008); no significant changes in VC or FEV1 post-surgery.

    Conclusions:

    • Pulmonary resection for bronchiectasis is associated with low complications.
    • Surgery markedly improves symptoms in most patients, particularly with complete resection.
    • Respiratory function is not adversely affected by pulmonary resection for bronchiectasis.