Current strategy for surgical management of bronchiectasis

Background. There are few current reports of surgical management for bronch iectasis because of its decline in prevalence, and it remains controversial as to which subgroups of patients would benefit from surgical management. Methods. We reviewed the medical records of all patients who underwent surg ical resection for bronchiectasis between January 1, 1990, and December 31, 1997, at our hospital. Results. Ninety patients underwent 92 operations for bronchiectasis. The me an age was 44.7 years. The presenting symptoms were productive cough in 82 patients, fever in 47 patients, hemoptysis in 35 patients, chest pain in 6 patients, and dyspnea on effort in 4 patients. The disease was bilateral in 13 patients. Complete resection was achieved in 75 patients. There was no operative mortality, and the morbidity rate was 19.6%. Postoperatively the patients were asymptomatic in 45.6%, improved in 38.0%, and showed no impro vement in 16.4%. Logistic regression extracted the type of bronchiectasis, the existence of sinusitis, and the type of resection for prognostic discri mination with statistical significance. Conclusions. Surgery for bronchiectasis can be performed with acceptable mo rbidity and mortality. Patients with cylindrical bronchiectasis are good su rgical candidates and chronic sinusitis is a risk factor for surgical resec tion. Complete resection should be done whenever possible. (C) 2001 by The Society of Thoracic Surgeons.