Surgical management of bronchiectasis in childhood

• Published in: European journal of cardio-thoracic surgery 2007-01, Vol.31 (1), p.120-123
• Main Authors: Sirmali, Mehmet, Karasu, Sezgin, Türüt, Hasan, Gezer, Suat, Kaya, Sadi, Taştepe, İrfan, Karaoğlanoğlu, Nurettin
• Format: Article
• Language: English
• Subjects: Adolescent; Bacterial diseases; Biological and medical sciences; Bronchiectasis - diagnosis; Bronchiectasis - etiology; Bronchiectasis - surgery; Child; Child, Preschool; Childhood bronchiectasis; Female; Human bacterial diseases; Humans; Infectious diseases; Length of Stay; Lung infections; Male; Medical sciences; Pneumology; Pneumonectomy - methods; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis; Tuberculosis and atypical mycobacterial infections
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2006.10.021

Objective: Though there is a gradual decrease in the prevalence of bronchiectasis, it is still a cause of mortality and morbidity among children in developing countries such as Turkey. We reviewed the morbidity and mortality rates and the outcome of surgical treatment for childhood bronchiectasis. Patients and methods: Age, sex, etiological factors, symptoms, radiological examinations, surgical procedures, postoperative morbidity and mortality in patients aged 16 years and younger, operated for bronchiectasis between January 1991 and April 2006 in the Thoracic Surgery Clinic of Atatürk Training and Research Hospital for Chest Disease and Chest Surgery were reviewed retrospectively. Results: Between January 1991 and April 2006, 176 cases aged 16 and younger were operated for bronchiectasis. There were 95 females (54%) and 81 males (46%), with a mean age of 12.3 years (range: 3.4–16 years). The most common cause of bronchiectasis was lung infection (n: 87, 49.4%). Main symptoms were coughing (n: 167, 94.9%), sputum (n: 139, 79%), hemoptysis (n: 78, 44.3%), and fever (n: 77, 43.7%). Mean duration of the symptoms in patients who were operated was 3.8 years (range: 0–7.6 years). Cases underwent a total of 201 operations: 19 cases had bilateral surgical resection and 6 cases had completion pneumonectomy. Majority of cases had complete resection (n: 165, 93.75%) while only 11 cases (6.25%) had incomplete resection. Mean duration of hospitalization was 8.9 days (range: 5–39 days). The outcome, based on the responses of patients postoperatively, was ‘perfect’ in 129 cases (73.3%), ‘improved’ in 41 cases (23.3%), and ‘no changes’ in 6 cases (3.4%). The mean follow-up after surgery was 4.3 years (range: 14 months to 7.2 years), mortality was 0% and morbidity was 13% (n: 23). Conclusion: With acceptable mortality and morbidity rates and high chance of cure after complete resection, surgical treatment is a successful and reliable method of treatment in childhood bronchiectasis that yields marked improvement in the quality of life.