Our Surgical Treatment Results in Bronchiectasis

Bronchiectasis still remains as a serious health problem for our country that surgery has an important role in its treatment. In this study, 9 patients (4 males and 5 females) operated with diagnosis of bronchiectasis between January 1995 and January 1999 in our department were retrospectively analyzed. The mean age was 27,7 (10-44). Computerized tomography was performed in 6 patients, high resolution computerized tomography in 2 patients and bronchography in 1 patient in order that diagnosis and surgical resection planning could be obtained. Operation endication in all patients was recurrent infection and excessive purulent sputum expectoration (in 2 patients, there was bronchial adenomas as well). The disease process was unilateral (in saccular type) in all cases and localized predominantly to the left inferior lobe (5 patients). Bronchoscopy was carried out in 5 patients so that ethiology could be clarified. Foreign body was found in 1 patient and bronchial adenoma in 2 patients. Surgical treatment was lobectomy in 6 patients (in one patient additional lingulectomy) and pneumonectomy in 3 patients. Postoperative atelectasy developed in 3 patients, although mortality was not seen. In long-term follow-up, recovery was obtained in 8 patients and clinical improvement in 1 patients. Curative resection should absolutely be applied in bronchiectasis which do not improve in spite of adequate and sufficient medical treatment, especially in saccular type.

Bronşektazide Cerrahi Tedavi Sonuçlarımız

Bronşektazi, ülkemiz için hala ciddi bir sağlık sorunu olup tedavisinde cerrahinin önemli bir yeri vardır. Bu çalışmada kliniğimizde Ocak 1995- Ocak 1999 yılları arasında bronşektazi tanısı ile opere edilen 9 hasta (4 erkek, 5 bayan) retrospektif olarak incelendi. Ortalama yaş 27.7 (10-44) idi. Tanı ve cerrahi rezeksiyonun planlanması amacıyla 6 hastaya bilgisayarlı tomografi, 2 hastaya yüksek rezolüsyonlu bilgisayarlı tomografi ve 1 hastaya da bronkografi yapıldı. Tüm hastalarda operasyon endikasyonu tekrarlayan enfeksiyon ve bol pürülan balgam çıkarma (2 hastada aynı zamanda bronş adenomu da vardı) idi. Tüm olgularda hastalık tek taraflı (sakküler tipte) ve ağırlıklı olarak da sol alt lobda lokalize idi (5 hasta). Beş hastaya etyolojiyi aydınlatabilmek amacıyla bronkoskopi yapıldı. Bir hastada yabancı cisim, iki hastada bronş adenomu saptandı. Cerrahi tedavi 6 hastada lobektomi (birinde ilaveten lingulektomi), 3 hastada pnömonektomi idi. Mortalite görülmezken 3 hastada postoperatif atalektazi gelişti. Uzun süreli takiplerde 8 hastada tam şifa, 1 hastada ise klinik düzelme görüldü. Uygun ve yeterli medikal tedaviye rağmen düzelmeyen bilhassa sakküler tip bronşektazilerde küratif rezeksiyon mutlaka uygulanmalıdır.