SURGERY FOR UNILATERAL BRONCHIECTASIS - RESULTS AND PROGNOSTIC FACTORS

Setting: King Khalid University Hospital referral centre for thoracic surgery, Riyadh, Saudi Arabia. Objective: To assess the results of sur gery and factors influencing its outcome in patients with unilateral b ronchiectasis. Design: A retrospective analysis of 40 patients with un ilateral bronchiectasis who were operated upon consecutively at King K halid Hospital, between July 1987 and May 1993. Results: Left-sided di sease was seen in 60% (n = 24) and right-sided in 40% (n = 16) of the patients. The entire lung was involved in 30% of cases (n = 12). Of th ese, the left lung was totally involved in 22.5% (n = 9) and the right in 7.5% (n = 3). A lobectomy was performed on 21 patients, basal segm entectomy with preservation of apical segment on 7, and pneumonectomy on 12. There was no operative mortality in this series. Six patients ( 15%) developed postoperative complications, bleeding (n = 4) and prolo nged air leak (n = 2). During an average follow-up period of 30.7 mont hs (+/-15.4 months), 29 patients (72.5%) were cured and the remaining 11 (27.5%) improved. No patients with Pseudomonas aeruginosa infection (n = 3) or obstructive airway disease (n = 5) were cured (P = 0.02 an d P = 0.002 respectively). Conclusion: Curative resection for selected patients with unilateral bronchiectasis can be performed safely with good results and low morbidity. Pseudomonas aeruginosa infection and o bstructive airway disease have an adverse effect on postoperative cure .