Surgical Management of Bronchiectasis an Experience of 100 Cases.

Abstract

Objective: To observe the various clinical presentations of bronchiectasis and evaluate its surgical management and outcome. Study Design: An observational descriptive study. Place and Duration: Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from July 2001 to January 2004. Materials and Methods: Computerized clinical data of 100 patients surgically managed during two and a half years was retrospectively analyzed. Detailed scrutiny of the record was carried out to determine various procedures done and analyze the clinical outcome. Results: A total of 100 patients underwent various surgical procedures. Male: Female ratio was 78: 22; age range was 15— 48 years with a mean age of 23.7 years. The predominant clinical presentations were productive cough in 55 (55%); recurrent chest infections in 30 (30%) and hemoptysis in 15(15%) patients. The mean operative time was 68 (40 ±) minutes. Seventy (70%) patients underwent lobectomy, 15(15%) pneumonectomy, 6 (6%) bilobectomy and lingulectomy in 5 (15%). Postoperative morbidity was 6(6%). Three patients required ventilatory support postoperatively; prolonged air leak was noted in 2 post-resection empyema in one patient. There was one mortality due to ventilatory failure. This was a 45 year old male patient who developed respiratory distress postoperatively and could not come off ventilator. Seventy two (72% patients were asymptomatic in the follow-up, 24 (24%) experienced improvement in symptoms and in 4 (4%) patients symptoms were unchanged. Conclusion: Surgical resection for bronchiectasis can be performed with acceptable morbidity and mortality at any age.