Surgical management of bronchiectasis: What quality of life?
Journal Title: JOURNAL OF FUNCTIONAL VENTILATION AND PULMONOLOGY - Year 2019, Vol 10, Issue 31
Abstract
Introduction. The dilation of the bronchi is a serious disease, potentially disabling, causing a social repercussion. Methods. This retrospective study evaluates the indications and results of 41 patients operated for bronchiectasis performed at the Department of Thoracic Surgery of the University Hospital of Oujda, Morocco, during a period between 2009-2017, as well as an evaluation of the quality of life after surgery. Results. The average age was 33. 14 years (range 5 to 60 years). There are 30 women (75%) and 11 men (25%). A history of recurrent respiratory infection was noted in 10 patients (33.3%), and pulmonary tuberculosis treated in 9 cases (30%). The circumstances of discovery are mainly dominated by chronic bronchorrhea found in 30 patients (73.1%), recurrent hemoptysis in 15 cases (36.5%), and chronic cough in 10 cases (24.39%). ). The CT scan showed cystic lesions in 22 cases (53.6%), cylindrical lesions in 13 cases (31.7%), cylindro-cystic lesions in 3 cases (7.3%), and a destroyed lung aspect in 3 case (7.3%). Bronchiectasis was unilateral in 29 cases (70.73%) and bilateral in 12 cases (29.2%). Medical treatment has been systematic in all our patients (antibiotics, mucolytics and respiratory physiotherapy). 31 (75.60%) our patients were managed by posterolateral or lateral thoracotomy, and 10 (24.39%) by video-thoracoscopy, of which 11 cases (26.82%) were operated in 2 steps for bilateral bronchiectasis. The intervention consisted of lobectomy in 20 cases (48.78%), pneumonectomy in 5 cases (12.19%), lobectomy associated with atypical resection in 4 cases (9.75%), segmentectomy 5 cases (12.19%), atypical resection in 4 cases (9.75%), biobectomy in 3 cases (7.31%). Postoperative complications were noted in 7 cases (17.07%). Conclusion. Bronchiectasis surgery is a treatment method of choice for well-selected patients, since it can heal or improve their quality of life by up to 90%. Complete resection is the only guarantee of better long-term functional results.
Authors and Affiliations
Rachid MAROUF
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