title: Lung resection improves the quality of life of patients with symptomatic bronchiectasis.
abstract: BACKGROUND
  Bronchiectasis is a significant cause of morbidity. Surgical resection is a treatment option, but its main outcomes regarding quality of life (QOL) and physiologic consequences have not been addressed previously, to our knowledge. We aimed to evaluate the effect of surgical procedures on QOL, exercise capacity, and lung function in patients with bronchiectasis in whom medical treatment was unsuccessful.
  
  
  METHODS
  Patients with noncystic fibrosis in whom medical treatment was unsuccessful and who were candidates for lung resection were enrolled in a prospective study. The main measurements before lung resection and 9 months afterward were QOL according to the Short Form 36 Health Survey and World Health Organization Quality of Life Questionnaires, lung function test results, and the results of maximal cardiopulmonary exercise testing on a cycle ergometer.
  
  
  RESULTS
  Of 61 patients who were evaluated, 53 (50.9% male, age 41.3 ± 12.9 years) underwent surgical resection (83% lobectomies), and 44 completed the 9-month follow-up. At baseline, they had low QOL scores, mild obstruction, and diminished exercise capacity. After resection, 2 patients died and adverse events occurred in 24.5%. QOL scores improved remarkably at the 9-month measurements, achieving values considered normal for the general population in most dimensions. Functionally, resection caused mild reduction of lung volume; nevertheless, exercise capacity was not decreased. In fact, 52% of the patients improved their exercise performance. Multiple linear regression analysis showed that low QOL before resection was an important predictor of QOL improvement after resection (p = 0.0001).
  
  
  CONCLUSIONS
  Lung resection promotes a significant improvement in the QOL of patients with noncystic fibrosis bronchiectasis without compromising their exercise capacity.
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Camilla Carlini
authors.initials: CC
authors.lastname: Vallilo
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Electronic address: rmterra@uol.com.br.
authors.forename: Ricardo Mingarini
authors.initials: RM
authors.lastname: Terra
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: André Luis Pereira
authors.initials: AL
authors.lastname: de Albuquerque
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Milena Mako
authors.initials: MM
authors.lastname: Suesada
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Alessandro Wasum
authors.initials: AW
authors.lastname: Mariani
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: João Marcos
authors.initials: JM
authors.lastname: Salge
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Priscila Berenice
authors.initials: PB
authors.lastname: da Costa
authors.affiliation: Thoracic Surgery Division and Pulmonology Division, Heart Institute (INCOR) Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Paulo Manuel
authors.initials: PM
authors.lastname: Pêgo-Fernandes
mesh_terms: D000328:Adult; D001987:Bronchiectasis / Q000601:surgery*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012129:Respiratory Function Tests