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支气管扩张症的外科治疗:我们23年的经验

Surgical treatment of bronchiectasis: Our 23 years of experience.

作者信息

Gülhan Selim Şakir Erkmen, Acar Leyla Nesrin, Sayılır Güven Ebru, Bıçakçıoğlu Pınar, Aydın Ertan, Karasu Sezgin, Taştepe Abdullah İrfan, İncekara Funda, Kaya Sadi, Fındık Göktürk

机构信息

Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.

Department of Thoracic Surgery, Liv Private Hospital, Ankara, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Oct 21;28(4):629-637. doi: 10.5606/tgkdc.dergisi.2020.19389. eCollection 2020 Oct.

Abstract

BACKGROUND

In this study, we aimed to evaluate the success of surgery and a complete resection for bronchiectasis treatment and to present our 23 years of surgical experience.

METHODS

Between January 1991 and December 2013, a total of 1,357 patients (667 males, 690 females; mean age 30.5±14.3 years; range, 3 to 73 years) with the diagnosis of bronchiectasis who underwent pulmonary resection in our clinic were retrospectively analyzed. Demographic and clinical characteristics of the patients, etiologies, symptoms, localizations, surgical procedures, and long-term follow-up results were evaluated.

RESULTS

There were 1,394 surgeries, as 37 (2.7%) patients had bilateral disease. The surgical procedures included lobectomy (n=702, 50.3%), pneumonectomy (n=183, 13.1%), segmental resections (n=114, 8.2%), bilobectomy (n=83, 6.0%), and lobectomy + segmentectomy (n=312, 22.4%). During the postoperative period, 1,269 (93.5%) patients were followed at a mean duration of 51.6 (range, 1 to 120) months. After surgery, 774 (61%) patients were asymptomatic, 456 (35.9%) showed an improvement, and 39 (3.1%) had no response or deterioration.

CONCLUSION

The surgical treatment plays an important role in the clinical and symptomatic improvement of patients with bronchiectasis. Surgery reduces the morbidity and mortality rates with careful preoperative preparation and appropriately selected cases.

摘要

背景

在本研究中,我们旨在评估手术治疗支气管扩张症的成功率及完全切除率,并展示我们23年的手术经验。

方法

回顾性分析1991年1月至2013年12月期间在我院接受肺切除术的1357例支气管扩张症患者(男性667例,女性690例;平均年龄30.5±14.3岁;年龄范围3至73岁)。评估患者的人口统计学和临床特征、病因、症状、病变部位、手术方式及长期随访结果。

结果

共进行了1394例手术,因为37例(2.7%)患者为双侧病变。手术方式包括肺叶切除术(n = 702,50.3%)、全肺切除术(n = 183,13.1%)、肺段切除术(n = 114,8.2%)、双肺叶切除术(n = 83,6.0%)以及肺叶切除术+肺段切除术(n = 312,22.4%)。术后,1269例(93.5%)患者得到随访,平均随访时间为51.6个月(范围1至120个月)。术后,774例(61%)患者无症状,456例(35.9%)症状改善,39例(3.1%)无反应或病情恶化。

结论

手术治疗在支气管扩张症患者的临床症状改善方面发挥着重要作用。通过仔细的术前准备和适当选择病例,手术可降低发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3059/7759052/f2ba578f7186/TJTCS-2020-28-4-629-637-F1.jpg

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