Yuncu G, Ceylan K C, Sevinc S, Ucvet A, Kaya S O, Kiter G, Unsal S, Ozsinan F
Thoracic Surgery Department, Pamukkale University Medical School, Denizli, Turkey.
Arch Bronconeumol. 2006 Apr;42(4):183-8. doi: 10.1016/s1579-2129(06)60440-0.
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.
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 6th postoperative month.
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).
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.
近几十年来，发达国家支气管扩张症的患病率显著下降。然而，在土耳其等发展中国家，支气管扩张症的手术切除在胸外科实践中仍起着重要作用。本研究旨在评估支气管扩张症手术治疗的效果，特别是在对功能健康影响方面。
1995年1月至2003年12月，对81例患者进行了支气管扩张症手术。评估了人口统计学特征、切除类型以及手术发病率和死亡率。根据术前和术后第6个月评估患者健康状况的量表，对与整体“社会”或非肺部功能状态相关的结果进行分类和比较。
平均年龄为24.4岁，47例（58%）为男性。37例（45%）手术为肺叶切除术，10例（12%）为全肺切除术，13例（16%）为肺段切除术，22例（27%）为肺叶切除加肺段切除术。69例（85%）患者实现了疾病的完全切除。无手术死亡。发病率为18.3%。81.7%的患者功能状态改善为优秀等级，12.7%的患者改善为良好等级；5.6%的患者无变化。完全切除的结果明显优于不完全切除（P = 0.0015）。
本系列支气管扩张症手术治疗的功能结果表明，效果良好且前景乐观，特别是对于有足够肺储备且疾病局限、适合完全切除的特定患者。
