The role of current surgical therapy for pediatric/adolescent and adult patients with bronchiectasis

Abstract

Background: This study aims to compare clinical manifestations, surgical indications, surgical procedures, postoperative complications, and outcomes of surgical treatment in pediatric and adult patients with bronchiectasis.

Methods: Between January 2000 and December 2013, a total of 99 patients (40 males, 59 females; mean age 33.3 years; range 10 to 67 years) who underwent surgery for bronchiectasis at the Department of Thoracic Surgery were retrospectively analyzed. Group 1 (n=28) were pediatric patients (<= 18 years) and group 2 (n=71) were adult patients (>18 years). Clinical symptoms, criteria surgical treatments applied, surgical treatment approaches, postoperative complications, the length of hospital stay, and treatment outcomes were evaluated.

Results: In both groups, the most common symptom was productive cough, followed by recurrent infections. There were no significant differences in the frequency of these symptoms between the groups. In total, 104 surgeries were performed. Of 29 surgeries in group 1, 26 were thoracotomies and three were video-assisted thoracoscopic surgery. Of 75 surgeries in group 2, 60 were thoracotomies and 15 were video-assisted thoracoscopic surgery. Postoperative complications were seen in eight operations (27.6%) in group 1 and 18 operations (24%) in group 2. There was no intra- or postoperative mortality. All 28 patients in group 1 showed improvement after surgery, while 23 outcomes (82.1%) were rated excellent (complete remission) and five outcomes (17.9%) were rated improved (reduced symptoms). In group 2, 63 outcomes (88.7%) were excellent and seven outcomes (9.9%) were rated improved; however, one patient (1.4%) showed no improvement.

Conclusion: In selected cases, surgical treatment for bronchiectasis is satisfactory and associated with acceptable mortality and morbidity rates, irrespective of the age of the patient. Based on our study results, surgery can cure this condition and can improve the quality of life, even when not curative.