Stephen Thomas, Thankachen Roy, Madhu Andrew P, Neelakantan Nithya, Shukla Vinayak, Korula Roy J
Cardiothoracic Surgery Unit II, Christan Medical College, Vellore 632 004, India.
Asian Cardiovasc Thorac Ann. 2007 Aug;15(4):290-6. doi: 10.1177/021849230701500405.
Bronchiectasis remains a serious problem in developing countries. We reviewed the morbidity, mortality, and functional outcome of surgical treatment for bronchiectasis in our institution. Between 1992 and 2003, 149 patients (105 males, 44 females) underwent pulmonary resection for bronchiectasis. Their mean age was 33.7 years (range, 5-66 years). The indications for surgery were failure of conservative treatment in 59 (40%) patients, recurrent hemoptysis in 53 (36%), bronchial obstruction by a tumor in 9 (6%), and destroyed lung in 28 (19%). Bilateral disease was seen in 24 (16%) patients. Surgical treatment included pneumonectomy in 55 (37%) patients, lobectomy in 55 (37%), bilobectomy in 37 (25%), and lobectomy and/or segmentectomy in 2 (1%). There was one operative death (mortality, 0.67%) and morbidity occurred in 22 (14.8%) patients. Follow-up was complete in 94 patients, for a mean of 4.8 years (range, 3 months to 12 years). After surgery, 51 (34%) patients were asymptomatic. Surgical treatment for bronchiectasis can achieve good results with acceptable morbidity and mortality, not only in localized disease but also in extensive disease, if complete resection can be achieved.
支气管扩张在发展中国家仍是一个严重问题。我们回顾了我院支气管扩张手术治疗的发病率、死亡率及功能转归。1992年至2003年间，149例患者（男105例，女44例）因支气管扩张接受了肺切除术。他们的平均年龄为33.7岁（范围5 - 66岁）。手术适应证为：59例（40%）患者保守治疗失败，53例（36%）反复咯血，9例（6%）肿瘤致支气管阻塞，28例（19%）肺毁损。24例（16%）患者为双侧病变。手术方式包括：55例（37%）全肺切除术，55例（37%）肺叶切除术，37例（25%）双叶切除术，2例（1%）肺叶切除和/或段切除术。有1例手术死亡（死亡率0.67%），22例（14.8%）患者发生并发症。94例患者获得完整随访，平均随访4.8年（范围3个月至12年）。术后，51例（34%）患者无症状。支气管扩张的手术治疗，若能实现完整切除，不仅对局限性病变，而且对广泛性病变，均可取得良好效果，且发病率和死亡率可接受。
