title: Current surgical therapy for bronchiectasis: surgical results and predictive factors in 86 patients.
abstract: BACKGROUND
  This study retrospectively evaluated the surgical indications and outcomes of 86 patients with bronchiectasis.
  
  
  METHODS
  Between 2000 and 2013, the clinical and surgical specifications as well as follow-up results of patients with bronchiectasis were reviewed. Cystic and cylindric morphologic features were determined by chest computed tomography and hemodynamics (perfused and nonperfused), by lung ventilation/perfusion scans. The main indication for surgical resection was localized areas of cystic, nonperfused bronchiectasis.
  
  
  RESULTS
  Patients were a mean age of 37.8 ± 14.5 years. Symptom duration was 43.4 ± 36.9 months. Bronchiectasis was saccular in 66 patients (76.7%) and varicose in 20 (23.3%). Localized defects were limited in one region of the lung in 53 (61.6%), and 54 (62.8%) showed a mixed or an obstructive ventilatory pattern. Failure of medical therapy was the most common indication for pulmonary resection. The 86 patients underwent 98 operations. Ten underwent staged thoracotomies (contralateral lobectomy, 7; contralateral segmentectomy, 3). Complete resection of all bronchiectatic areas was done in 78 patients (90.7%). Complications developed in 14 patients (14.6%). The mortality rate was 1.1% (n = 1). After surgical treatment, 71 of 86 patients (82.5%) were free of symptoms (excellent), and the remaining 15 (17.5%) had a reduction in preoperative symptoms. The 53 patients with localized perfusion defects underwent complete resection and had symptom-free (excellent) postoperative results. Complete resection independently predicted symptom-free outcome (p < 0.05); a forced expiratory volume in 1 second of less than 60% of the predicted value, an incomplete resection, and a preoperative antibiotic therapy independently predicted postoperative complications (p < 0.05).
  
  
  CONCLUSIONS
  Bronchiectasis can be improved with operation. In properly selected patients, pulmonary resection can be done with acceptable morbidity and mortality rates and can lead to lasting symptomatic improvements.
authors.affiliation: Department of Thoracic Surgery, Euphrates University Hospital, Elazig, Turkey. Electronic address: abalci.journals@hotmail.com.
authors.forename: Akın Eraslan
authors.initials: AE
authors.lastname: Balci
authors.affiliation: Department of Nuclear Medicine, Euphrates University Hospital, Elazig, Turkey.
authors.forename: Tansel Ansal
authors.initials: TA
authors.lastname: Balci
authors.affiliation: Department of Thoracic Surgery, Euphrates University Hospital, Elazig, Turkey.
authors.forename: Mehmet Oğuzhan
authors.initials: MO
authors.lastname: Ozyurtan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011237:Predictive Value of Tests; D013510:Pulmonary Surgical Procedures / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
keywords: 11