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

Background: Bronchiectasis 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...

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Main Authors: D. Coutinho, P. Fernandes, M. Guerra, J. Miranda, L. Vouga
Format: Article
Language:English
Published: Elsevier 2016-03-01
Series:Revista Portuguesa de Pneumologia (English Edition)
Online Access:http://www.sciencedirect.com/science/article/pii/S2173511515001785
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author D. Coutinho
P. Fernandes
M. Guerra
J. Miranda
L. Vouga
author_facet D. Coutinho
P. Fernandes
M. Guerra
J. Miranda
L. Vouga
author_sort D. Coutinho
collection DOAJ
description Background: Bronchiectasis 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. Methods: Between 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. Results: From 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%). Conclusion: Although 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. Keywords: Bronchiectasis, Thoracic surgery
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spelling doaj.art-58624cf7f1b94748be4b4c2e7aa2fbfb2022-12-22T00:47:34ZengElsevierRevista Portuguesa de Pneumologia (English Edition)2173-51152016-03-012228285Surgical treatment of bronchiectasis: A review of 20 years of experienceD. Coutinho0P. Fernandes1M. Guerra2J. Miranda3L. Vouga4Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal; Corresponding author.Cardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, PortugalCardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, PortugalCardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, PortugalCardiothoracic Surgery Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, PortugalBackground: Bronchiectasis 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. Methods: Between 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. Results: From 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%). Conclusion: Although 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. Keywords: Bronchiectasis, Thoracic surgeryhttp://www.sciencedirect.com/science/article/pii/S2173511515001785
spellingShingle D. Coutinho
P. Fernandes
M. Guerra
J. Miranda
L. Vouga
Surgical treatment of bronchiectasis: A review of 20 years of experience
Revista Portuguesa de Pneumologia (English Edition)
title Surgical treatment of bronchiectasis: A review of 20 years of experience
title_full Surgical treatment of bronchiectasis: A review of 20 years of experience
title_fullStr Surgical treatment of bronchiectasis: A review of 20 years of experience
title_full_unstemmed Surgical treatment of bronchiectasis: A review of 20 years of experience
title_short Surgical treatment of bronchiectasis: A review of 20 years of experience
title_sort surgical treatment of bronchiectasis a review of 20 years of experience
url http://www.sciencedirect.com/science/article/pii/S2173511515001785
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AT jmiranda surgicaltreatmentofbronchiectasisareviewof20yearsofexperience
AT lvouga surgicaltreatmentofbronchiectasisareviewof20yearsofexperience