Lung Resection for Bronchiectasis – A Single Center Nine Year Experience of 303 Cases and Comparison with Our Earlier Study

Birla R. Gnanamuthu, Nishok David

The christian medical college hospital, vellore, India

Date, time and location: 2018.05.25 10:30, Press Hall, 2F

Abstract

Introduction:  Bronchiectasis is a leading cause for lung resections in developing countries. A study of 149 such patients was done in our institution between 1992 and 2003. Between 2009 and 2017, a further 303 patients, operated by a single surgeon, were studied to compare with the earlier study.

Materials and Methods: The details of adult patients who underwent surgery for bronchiectasis were retrieved from database and analyzed.

Results: Bronchiectasis caused 43% of lung resections.The sex ratio was 192:111. The average age was 36.95 years. Haemoptysis (63%) was the commonest symptom making patients present early for surgery (51 months). No emergency surgeries were performed for massive haemoptysis due to successful of embolizations.

Bronchography was not performed beyond the year 2000. 52% of the patient had been treated for tuberculosis and none had evidence of active Tuberculosis. The commonest single lobe resected was the right upper lobe (16%). Left lower lobe with lingula was the commonest bilobectomy done (5%). Limited resections were done in 5% and pneumonectomies in 10.8%. Four patients had sequential bilateral surgeries.

Histopathology revealed Aspergilloma in 32%, invasive aspergilloma in 6, and tuberculosis 11.8%.

One surgery was abandoned due to excessive bleeding and another re-explored. There were 4 post operative empyema and two immediate post operative deaths. The average post operative stay was 7.8 days. 69% of the patients were followed up (average 15.8 months) and 90% of them had improved of quality of life.

Conclusion: Bronchiectasis continues to be a major cause of lung resections in India. Tuberculosis is still major factor. Increased usage of staplers has improved the efficacy of resections resulting in better patient satisfaction. Surgical resection, when medical management fails, improves the quality of life significantly.