Surgical treatment of bronchiectasis

Thirty-six patients with non-tuberculous bronchiectasis underwent pulmonary resection in our hospital from July 1988 to June 1995. All patients suffered from significant symptoms that did not respond to medical treatment, and repeated hemoptysis (80%) associated with cough and productive purulent sputum was the leading indication for operation. Thirty one patients with unilateral bronchiectatic lesions required resection of diseased lung tissue, and the remaining 5 patients with bilateral lesions required simultaneous bilateral pulmonary resections. Among all patients, two (6%) underwent resection of more than 10 lung segments and 9 (25%) underwent pneumonectomy with left predominated. There was no operative death, but 5 patients (13.5%) had significant complications consisting of empyema (n=3) and bronchopleural fistula (n=2). The empyema in all these 3 patients was treated by thoracocentesis, and the bronchopleural fistula in both patients by bronchial closure and thoracoplasty. All the operative complications were properly treated, and these patients completely recovered. Sixteen patients had available preoperative and postoperative pulmonary function did not have significant changes as compared with the preoperative one. All the patients finally achieved relief of symptoms. Two patients who underwent resection of more than 10 lung segments had been free from infection and disability, and returned to work. It is concluded that in properly selected bronchiectatic patients, complete resection of diseased lung tissues can provide a definite benefit for their symptomatic improvement.