Lung resection for bronchiectasis in children
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O Zamir1, O Z Lernau, C Springer
1Department of General and Paediatric Surgery, Hadassah University Hospital Mount Scopus, Jerusalem, Israel.
Insights
Surgical resection of localized bronchiectasis in children offers significant symptom relief. Pulmonary resections are indicated for pediatric patients with persistent symptoms unresponsive to medical management.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Thoracic Surgery
Background:
- Bronchiectasis in children presents significant challenges, often requiring intervention when medical management fails.
- Localized disease and specific etiologies like foreign body aspiration necessitate tailored treatment approaches.
Purpose of the Study:
- To evaluate the efficacy and outcomes of pulmonary resections in pediatric patients with symptomatic, localized bronchiectasis.
- To identify common etiologies and postoperative complications associated with surgical intervention.
Main Methods:
- Retrospective review of twenty children with bronchiectasis who underwent pulmonary resections over an 8-year period.
- Analysis of patient demographics, etiology, surgical procedures, postoperative complications, and long-term follow-up outcomes.
Main Results:
- Pulmonary resections were performed on twenty children with significant, localized bronchiectasis unresponsive to medical treatment.
- Lower lobes were most frequently affected; foreign body aspiration was a common cause (7 patients).
- Fifteen of eighteen patients undergoing curative resection achieved long-term asymptomatic status, with atelectasis being the most common complication.
Conclusions:
- Pulmonary resection is a viable and effective treatment for children with localized bronchiectasis refractory to medical therapy.
- Surgical intervention can lead to significant long-term symptom improvement and a good quality of life in pediatric patients.
Abstract:
Twenty children with bronchiectasis underwent pulmonary resections during an 8-year period. All patients suffered from significant symptoms that did not respond to medical treatment and had localised disease. In 7 patients bronchiectasis developed following foreign body aspiration and in two the aetiology was cystic fibrosis and immune deficiency, respectively. The lower lobes were most commonly involved. Atelectasis of the remaining ipsilateral lung was the most common postoperative complication occurring in four patients. One patient required reoperation for recurrent symptoms. Fifteen out of 18 patients who underwent curative resections were asymptomatic in the longterm follow-up. It is concluded that for children with significant symptoms due to localised bronchiectasis that fails to respond to medical treatment, resection of the affected lobes is indicated.