Pulmonary Resection for Bronchiectasis: Perioperative and Follow-Up Outcomes in a VATS-Dominant Cohort

Background/Objectives: Surgical resection remains an important treatment option for selected patients with bronchiectasis who have persistent symptoms, recurrent pulmonary infections, or hemoptysis despite medical therapy. This study evaluated perioperative and follow-up outcomes after pulmonary resection for bronchiectasis in a predominantly video-assisted thoracoscopic surgery (VATS)-treated cohort. Methods: This retrospective single-center cohort included patients who underwent pulmonary resection for bronchiectasis between January 2009 and January 2026. Baseline and follow-up data were analyzed at the patient level, whereas operative and perioperative outcomes were assessed at the procedure level. Follow-up duration was calculated from the most recent resection to the last available clinical assessment. Results: Thirty-four patients underwent 37 pulmonary resections. Multilobar disease was present in 14 procedures (37.8%). VATS was used in 30 procedures (81.1%) and thoracotomy in 7 (18.9%). Median hospital stay was 11 days (range, 4-41). Postoperative complications occurred after 6 procedures (16.2%), with no 30-day mortality. Complete or partial symptomatic improvement occurred after 31 procedures (83.8%). Median follow-up was 20.8 months (interquartile range, 5.9-58.8; range, 0.4-144.2). At the last available clinical assessment, 23 patients (67.6%) had no recorded symptoms; recurrent hemoptysis occurred in 1 (2.9%) and recurrent pulmonary infection in 2 (5.9%). Conclusions: Pulmonary resection for bronchiectasis was associated with acceptable morbidity, no 30-day mortality, and a high rate of postoperative clinical improvement in this VATS-dominant cohort. Most patients had no recorded symptoms at their last available clinical assessment, while recurrent hemoptysis and pulmonary infection were uncommon.