title: Limited operation for severe multisegmental bilateral bronchiectasis.
abstract: BACKGROUND
  Some patients exhibiting severe multisegmental bilateral bronchiectasis are no longer improved with antibiotic treatment and drainage and, most of the time, operation is contraindicated. In our institution, limited operation has been offered to select patients for this indication. We report our data regarding the feasibility and utility of such a procedure.
  
  
  METHODS
  We studied 16 patients who underwent surgical removal of nonlocalized disease between 1990 and 1999. We report the mortality and morbidity rates of this surgical procedure and the clinical, bacteriological, and functional data for each patient.
  
  
  RESULTS
  There was no mortality and the morbidity was low (18%, all with favorable outcome). Symptoms such as hemoptysis, sputum production, or dyspnea were also improved. The recurring infections decreased in frequency in 8 patients and disappeared completely in 5 others. The bacteriological data assessment revealed disappearance of germs in 4 patients and persistence of chronic colonization in others. Postoperative spirometric data were not worsened and postoperative computed tomographic scans did not show progression of lesions not removed.
  
  
  CONCLUSIONS
  These results suggest that, in properly selected patients, lasting symptomatic improvement can be achieved by resection. Limited operation may be indicated in nonlocalized bilateral bronchiectasis, provided that a target can be identified. This procedure is supported by physiopathologic arguments and is particularly relevant to patients with bronchiectasis with cystic and functionless territories.
authors.affiliation: Department of Pulmonary Diseases, Rangueil Hospital, University of Toulouse, Toulouse, France. mazieres.j@chu-toulouse.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Mazières
authors.forename: Marléne
authors.initials: M
authors.lastname: Murris
authors.forename: Alain
authors.initials: A
authors.lastname: Didier
authors.forename: Jacques
authors.initials: J
authors.lastname: Giron
authors.forename: Marcel
authors.initials: M
authors.lastname: Dahan
authors.forename: Jean
authors.initials: J
authors.lastname: Berjaud
authors.forename: Paul
authors.initials: P
authors.lastname: Léophonte
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D013147:Spirometry; D014057:Tomography, X-Ray Computed