Journal Information
Vol. 42. Issue 4.
Pages 183-188 (April 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 4.
Pages 183-188 (April 2006)
Original Articles
Full text access
Functional Results of Surgical Treatment of Bronchiectasis in a Developing Country
Visits
4825
Gokhan Yuncua,
Corresponding author
gyuncu@pamukkale.edu.tr

Correspondence: Dr. Gokhan Yuncu. Pamukkale University Medical School, Kinikli Kampus Denizli/Turkey
, Kenan Can Ceylanb, Serpil Sevinca, Ahmet Ucvetb, Seyda Ors Kayaa, Goksel Kiterc, Saban Unsalb, Funda Ozsinanb
a Pamukkale University Medical School, Thoracic Surgery Department, Denizli, Turkey
b Chest Diseases and Thoracic Surgery Training Hospital, First Department of Thoracic Surgery, Izmir, Turkey
c Pamukkale University Medical School, Chest Diseases Department, Denizli, Turkey
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Background

The prevalence of bronchiectasis has decreased significantly over recent decades in developed countries. However, resection for bronchiectasis still plays an important part in thoracic surgery practice in developing countries such as Turkey. This study was designed to evaluate the outcomes of surgical treatment for bronchiectasis, particularly in aspects related to the effects on functional well-being.

Patients and method

From January 1995 through December 2003, operations for bronchiectasis were performed in 81 patients. Demographic features, type of resection, and operative morbidity and mortality were evaluated. The outcomes related to overall “social” or nonpulmonary functional status were classified and compared according to a scale constructed to assess patients' well-being preoperatively and at the sixth postoperative month.

Results

The mean age was 24.4 years and 47 patients (58%) were male. Surgical treatment was lobectomy in 37 (45%), pneumonectomy in 10 (12%), segmentectomy in 13 (16%), and lobectomy plus segmentectomy in 22 (27%) of the operations. Complete resection of disease was achieved in 69 patients (85%). There was no operative mortality. The rate of morbidity was 18.3%. Improvement to a functional status of excellent was observed in 81.7% and improvement to a status of good was seen in 12.7% of patients; 5.6% experienced no change. The results of complete resection were significantly better than those of incomplete resection (P=.0015).

Conclusion

Functional results of surgical treatment for bronchiectasis in this series suggest that the outcomes are favorable and promising, particularly in selected patients with sufficient pulmonary reserves and localized disease who are suitable for complete resection.

Key words:
Bronchiectasis
Surgery
Outcome assessment
Objetivo

La prevalencia de las bronquiectasias ha disminuido significativamente durante los últimos decenios en los países desarrollados. Sin embargo, la resección quirúrgica de las bronquiectasias desempeña todavía un papel importante en la práctica de la cirugía torácica en los países en vías de desarrollo como Turquía. El presente estudio se ha diseñado para evaluar los resultados obtenidos con el tratamiento quirúrgico de las bronquiectasias, especialmente en lo que se refiere a sus efectos sobre el bienestar funcional de los pacientes.

Patientes y método

Entre enero de 1995 y diciembre de 2003 recibieron tratamiento quirúrgico debido a bronquiectasias 81 pacientes. Se evaluaron las características demográficas, el tipo de resección quirúrgica y la morbilidad y mortali-dad operatorias. Los resultados relativos al nivel funcional global “social” o extrapulmonar se clasificaron y compararon con una escala creada para determinar el grado de bienestar de los pacientes antes de la intervención y a los 6 meses.

Resultados

La edad media de los pacientes era de 24,4 años y 47 (58%) eran de sexo masculino. El tratamiento quirúrgico consistió en lobectomía en 37 (45%), neumonectomía en 10 (12%), segmentectomía en 13 (16%) y la combinación de lobectomía y segmentectomía en 22 (27%) de las intervenciones quirúrgicas. La resección completa se llevó a cabo en 69 pacientes (85%). No se produjo ningún fallecimiento a consecuencia de la cirugía. La tasa de morbilidad fue del 18,3%. Se observó mejoría hasta un estado funcional excelente en el 81,7% de los pacientes, así como mejoría hasta un estado funcional bueno en el 12,7%; en el 5,6% no se observaron cambios. Los resultados obtenidos con la resección completa fueron significativamente mejores que los conseguidos con la resección incompleta (p = 0,0015).

Conclusión

Los resultados funcionales del tratamiento quirúrgico de las bronquiectasias obtenidos en esta serie de pacientes son favorables y prometedores, especialmente en pacientes seleccionados con una reserva pulmonar suficiente y con un proceso patológico localizado en quienes es posible la resección completa.

Palabras clave:
Bronquiectasias
Cirugía
Evaluación de resultados
Full text is only aviable in PDF
REFERENCES
[1]
P van Trigt.
Lung infections and diffuse interstitial lung disease.
Surgery of chest, pp. 615-670
[2]
D Prieto, J Bernardo, MJ Matos, L Eugenio, M Antunes.
Surgery for bronchiectasis.
Eur J Cardiothorac Surg., 20 (2001), pp. 19-24
[3]
M Ashour, K al-Kattan, MA Rafay, KF Saja, W Hajjar, AR al-Fraye.
Current surgical therapy for bronchiectasis.
World J Surg., 23 (1999), pp. 1096-1104
[4]
T Agasthian, C Deschamps, VF Trastek, MS Allen, PC Pairolero.
Surgical management of bronchiectasis.
Ann Thorac Surg., 62 (1996), pp. 976-980
[5]
MA Martínez García.
Bronchiectasis: still an orphan disease?.
Arch Bronconeumol., 41 (2005), pp. 407-409
[6]
F Madsen.
Quality of Life Questionnaires for all respiratory diseases, every language, and ethnic minorities. Are alternatives available?.
Respir Med., 94 (2000), pp. 187-189
[7]
MA Martínez García, M Perpiñà Tordera, P Román Sánchez, JJ Soler Cataluña.
Internal consistency and validity of the Spanish version of the St George's Respiratory Questionnaire for use in patients with clinically stable bronchiectasis.
Arch Bronconeumol., 41 (2005), pp. 110-117
[8]
H Kutlay, AK Cangir, S Enön, E Sahin, M Akal, A Güngör, et al.
Surgical treatment in bronchiectasis: analysis of 166 patients.
Eur J Cardiothorac Surg., 21 (2002), pp. 634-637
[9]
T Fujimoto, L Hillejan, G Stamatis.
Current strategy for surgical management of bronchiectasis.
Ann Thorac Surg., 72 (2001), pp. 1711-1715
[10]
I Otgün, I Karnak, FC Tanyel, ME Senocak, N Büyükpamukcu.
Surgical treatment of bronchiectasis in children.
J Pediatr Surg., 39 (2004), pp. 1532-1536
[11]
A Vilas Iglesias, J Suárez Martínez.
Bronchiectasis due to Flavimonas oryzihabitans in an immunocompetent patient.
Arch Bronconeumol., 40 (2004), pp. 384-385
[12]
DN Campbell, JR Lilly.
The changing spectrum of pulmonary operations in infants and children.
J Thorac Cardiovasc Surg., 83 (1982), pp. 680-685
[13]
AF Barker.
Bronchiectasis.
Semin Thorac Cardiovasc Surg., 7 (1995), pp. 112-118
[14]
SA George, HK Leonardi, RH Overholt.
Bilateral pulmonary resection for bronchiectasis: a 40-year experience.
Ann Thorac Surg., 28 (1979), pp. 48-53
[15]
DF Blyth, NJ Buckels, R Sewsunker, MA Soni.
Pneumonectomy in children.
Eur J Cardiothorac Surg., 22 (2002), pp. 587-594

Parts of this paper were presented at the 17th Asia Pacific Congress on Diseases of the Chest, Istanbul, August 29—September 1, 2003.

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?