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Bronşektazi Cerrahisinin Uzun Dönem Sonuçları;108 Olgu

Year 2021, Volume: 5 Issue: 2, 140 - 145, 25.08.2021

Erkan Akar Miktat Arif Haberal

https://doi.org/10.46332/aemj.827315

Abstract

Amaç: Cerrahi rezeksiyon uygulayıp uzun süre takip ettiğimiz olguların sonuçlarını değerlendirmeyi amaçladık.

Araçlar ve Yöntem: 2005 ile 2019 tarihler arasında kliniğimize başvuran, bronşektazi tanısı alan ve opere edilen 108 hastanın dosyaları (38 erkek, 70 kadın; ortalama yaş 23.03 yıl (18-63)) geriye dönük olarak değerlendirildi. Ameliyat sonrası hastaların takipleri; akciğer grafisi, SFT, tam kan, CRP takibi ve ameliyat öncesi şikâyetleri (öksürük, balgam çıkarma, tekrarlayan akciğer enfeksiyonları) sorgulanıp kaydedildi. Hastaları ameliyat sonrası değerlendirirken, ameliyat öncesi şikâyetlerin olmaması, şikâyetlerin azalması ve değişiklik olmaması şeklinde kategorize edildi.

Bulgular: Yüz sekiz hastaya 115 cerrahi işlem yapıldı. Cerrahi sonrası en fazla görülen komplikasyon atelektazi ve uzamış hava kaçağı idi. Cerrahi olarak çoğunlukla lobektomi uygulandı. Postoperatif morbidite 44 hasta ile %41 idi. Mortalite ise 5 hasta ile %5 idi. Tam düzelme 87 hasta (%81), 15 hasta da (%14) ise şikâyetleri kabul edilebilir düzeyde ve antibiyotik kullanma gereksinimi vardı. Altı hastada (%5) ise başka lobda nüks etti. Hastalarımızın ortalama takip süresi 3.71 yıl (8 ay-12 yıl) idi.

Sonuç: Uygun olarak tedavi edilmeyen bronşektazi hastaları enfeksiyonların kısır döngüsü ile seyreder. Cerrahi tedaviyi gerektiren risk faktörleri morbiditeyi de belirler. Etkilenen dokuların cerrahi rezeksiyonu ile bu kısır döngü sonlandırılabilir.

Keywords

bronşektazi komplikasyon postoperatif rezeksiyon

Supporting Institution

yok

Project Number

yok

References

  • 1. Bilton D. Update on non-cystic fibrosis bronchiectasis. Curr Opin Pulm Med. 2008;14(6):595-599.
  • 2. Zhang P, Jiang G, Ding J, Zhou X, Gao W. Surgical Treatment of Bronchiectasis: A Retrospective Analysis of 790 Patients. Ann Thorac Surg. 2010;90(1):246–251.
  • 3. Özkan M, Sakallı MA, Yenigün BM, et al. Surgical Treatment in Bronchiectasis: Results of 191 Patients. J Ankara Univ Fac Med. 2019;72(2):241-246.
  • 4. Balci AE, Balci TA, Eren S, Nazaroglu H, Eren MN. Bronşektazide operasyonun rolü: Cerrahi ve medikal tedavinin karşılaştırması. Turk Gogus Kalp Dama. 2002;10(2):95-101.
  • 5. Giovannetti R, Alifano M, Stefani A, et al. Surgical treatment of bronchiectasis: early and long-term results. Interact Cardiovasc Thorac Surg. 2008;7(1):609-612.
  • 6. Ibarrola M, Solís M, Buero A, et al. Surgical Treatment of Bronchiectasis: A Retrospective Long-Term Analysis of 55 Patients. EC Pulm Resp Med. 2020;9(1):01-08.
  • 7. Kutlay H, Cangir AK, Enön S, et al. Surgical treatment in bronchiectasis: analysis of 166 patients. Eur J Cardiothorac Surg. 2002;21(4):634-637.
  • 8. Deslauriers J, Goulet S, Francois B. Surgical treatment of bronchiectasis and broncholithiasis. In: Franco LF, Putnam JB, editors. Advanced Therapy in Thoracic Surgery. Hamilton, ON: Decker;1998:300-309.
  • 9. Bagheri R, Haghi SZ, Fattahi MSH, Bahadorzadeh L. Surgical management of bronchiectasis: analysis of 277 patients. Thorac Cardiovasc Surg. 2010;58(5):291-294.
  • 10. Hodder RV, Cameron R, Todd TRJ. Bacterial infections. In: Pearson FG, editor. Thoracic Surgery. New York: Churchill Livingstone;1995.
  • 11. Sirmali M, Karasu S, Türüt H, et al. Surgical management of bronchiectasis in childhood. EurJ Cardiothorac Surg. 2007;31(1):120-123.
  • 12. Sunny SS, Davison J, De Soyza A. Management of non-cystic fibrosis Bronchiectasis. Clin Pract. 2013;10(5):629–640.
  • 13. Mathur M, Gupta S, Bhalla R, Mathur A. High Resolution Computed Tomography Assessment of Interstitial Lung Diseases and its Correlation with Spirometry Indices. J Clin Diag Res. 2017;11(11):7-12.
  • 14. Gallucci M, di Palmo E, Berteli L, Camela F, Ricci G, Pession A. A pediatric disease to keep in mind: diagnostic tools and management of bronchiectasis in pediatric age. Ital J Pediatr. 2017;43(1):117.
  • 15. Otgün I, Karnak I, Tanyel FC, Senocak ME, Büyükpamukçu N. Surgical treatment of bronchiectasis in children. J Pediatr Surg. 2004;39(10):1532-1536.
  • 16. Yuncu G, Ceylan KC, Sevinc S, et al. Functional results of surgical treatment of bronchiectasis in a developing country. Arch Bronconeumol. 2006;42(4):183-188.
  • 17. Doner E. Surgical Treatment of Bronchiectasis; Analysis of 2 Years. Osmangazi J Med. 2020;42(5):541-545.
  • 18. Balkanli K, Genç O, Dakak M, et al. Surgical management of bronchiectasis: analysis and short-term results in 238 patients. Eur J Cardiothorac Surg. 2003;24(5):699-702.
  • 19. Neves PC, Guerra M, Ponce P, Miranda J, Vouga L. Non-cystic fibrosis bronchiectasis. Interact Cardiovasc Thorac Surg. 2011;13(6):619-625.
  • 20. Al-Refaie RE, Amer S, El-Shabrawy M. Surgical treatment of bronchiectasis: a retrospective observational study of 138 patients. J Thorac Dis. 2013;5(3):228-233.
  • 21. Nadir A, Kaptanoğlu M, Gönlügür U, et al. Bronsektazinin cerrahi tedavisi: 36-olgunun değerlendirilmesi. T Klin J Med Sci. 2003:23(1):359-365.
  • 22. Gursoy S, Ozturk AA, Ucvet A, Erbaycu AE. Surgical management of bronchiectasis: the indications and outcomes. Surg Today 2010;40(1):26-30.
  • 23. Fan LC, Liang S, Lu HW, Fei K, Xu JF. Efficiency and safety of surgical intervention to patients with Non- Cystic Fibrosis bronchiectasis: a meta-analysis. Sci Rep. 2015;5(1):17382.

Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases

Year 2021, Volume: 5 Issue: 2, 140 - 145, 25.08.2021

Erkan Akar Miktat Arif Haberal

https://doi.org/10.46332/aemj.827315

Abstract

Purpose: We aimed to analyze the cases that we monitored for long term after applying surgical resection.

Materials and Methods: Admitted to our clinic between 2005 and 2019, the files of 108 patients (38 male, 70 female, mean age of 23.03 years (18-63)), who visited our clinic, were diagnosed with bronchiectasis and operated on, were retrospectively analyzed. For the monitoring of the patients after surgery, chest radiography, PFT, CBC and CRP follow-up results, and their preoperative complaints (coughing, expectoration, recurrent pulmonary infections) were examined and recorded. While assessing the patients’ status after the surgery, they were categorized as disappearance of the preoperative complaints, decrease in the complaints, and no change in the complaints.

Results: 115 surgical operations were carried out on 108 patients. The most frequently encountered complications after surgery were atelectasis and prolonged air leak. Mostly lobectomy was applied as surgery. Postoperative morbidity was seen in 44 patients (41%). Mortality was seen in 5 patients (5%). Complete recovery was observed in 87 patients (81%), while the complaints of 15 patients (14%) were on an acceptable level, and they needed to use antibiotics. The disease relapsed in another lobe in 6 patients (5%). The mean time of monitoring among our patients was 3.71 years (8 months - 12 years).

Conclusion: Infections fall into a vicious circle in bronchiectasis patients who are not appropriately treated. The risk factors that require surgery determine morbidity. This cycle may be ended by the surgical resection of the affected tissues. 

Keywords

bronchiectasis complication postoperative resection

Project Number

yok

References

  • 1. Bilton D. Update on non-cystic fibrosis bronchiectasis. Curr Opin Pulm Med. 2008;14(6):595-599.
  • 2. Zhang P, Jiang G, Ding J, Zhou X, Gao W. Surgical Treatment of Bronchiectasis: A Retrospective Analysis of 790 Patients. Ann Thorac Surg. 2010;90(1):246–251.
  • 3. Özkan M, Sakallı MA, Yenigün BM, et al. Surgical Treatment in Bronchiectasis: Results of 191 Patients. J Ankara Univ Fac Med. 2019;72(2):241-246.
  • 4. Balci AE, Balci TA, Eren S, Nazaroglu H, Eren MN. Bronşektazide operasyonun rolü: Cerrahi ve medikal tedavinin karşılaştırması. Turk Gogus Kalp Dama. 2002;10(2):95-101.
  • 5. Giovannetti R, Alifano M, Stefani A, et al. Surgical treatment of bronchiectasis: early and long-term results. Interact Cardiovasc Thorac Surg. 2008;7(1):609-612.
  • 6. Ibarrola M, Solís M, Buero A, et al. Surgical Treatment of Bronchiectasis: A Retrospective Long-Term Analysis of 55 Patients. EC Pulm Resp Med. 2020;9(1):01-08.
  • 7. Kutlay H, Cangir AK, Enön S, et al. Surgical treatment in bronchiectasis: analysis of 166 patients. Eur J Cardiothorac Surg. 2002;21(4):634-637.
  • 8. Deslauriers J, Goulet S, Francois B. Surgical treatment of bronchiectasis and broncholithiasis. In: Franco LF, Putnam JB, editors. Advanced Therapy in Thoracic Surgery. Hamilton, ON: Decker;1998:300-309.
  • 9. Bagheri R, Haghi SZ, Fattahi MSH, Bahadorzadeh L. Surgical management of bronchiectasis: analysis of 277 patients. Thorac Cardiovasc Surg. 2010;58(5):291-294.
  • 10. Hodder RV, Cameron R, Todd TRJ. Bacterial infections. In: Pearson FG, editor. Thoracic Surgery. New York: Churchill Livingstone;1995.
  • 11. Sirmali M, Karasu S, Türüt H, et al. Surgical management of bronchiectasis in childhood. EurJ Cardiothorac Surg. 2007;31(1):120-123.
  • 12. Sunny SS, Davison J, De Soyza A. Management of non-cystic fibrosis Bronchiectasis. Clin Pract. 2013;10(5):629–640.
  • 13. Mathur M, Gupta S, Bhalla R, Mathur A. High Resolution Computed Tomography Assessment of Interstitial Lung Diseases and its Correlation with Spirometry Indices. J Clin Diag Res. 2017;11(11):7-12.
  • 14. Gallucci M, di Palmo E, Berteli L, Camela F, Ricci G, Pession A. A pediatric disease to keep in mind: diagnostic tools and management of bronchiectasis in pediatric age. Ital J Pediatr. 2017;43(1):117.
  • 15. Otgün I, Karnak I, Tanyel FC, Senocak ME, Büyükpamukçu N. Surgical treatment of bronchiectasis in children. J Pediatr Surg. 2004;39(10):1532-1536.
  • 16. Yuncu G, Ceylan KC, Sevinc S, et al. Functional results of surgical treatment of bronchiectasis in a developing country. Arch Bronconeumol. 2006;42(4):183-188.
  • 17. Doner E. Surgical Treatment of Bronchiectasis; Analysis of 2 Years. Osmangazi J Med. 2020;42(5):541-545.
  • 18. Balkanli K, Genç O, Dakak M, et al. Surgical management of bronchiectasis: analysis and short-term results in 238 patients. Eur J Cardiothorac Surg. 2003;24(5):699-702.
  • 19. Neves PC, Guerra M, Ponce P, Miranda J, Vouga L. Non-cystic fibrosis bronchiectasis. Interact Cardiovasc Thorac Surg. 2011;13(6):619-625.
  • 20. Al-Refaie RE, Amer S, El-Shabrawy M. Surgical treatment of bronchiectasis: a retrospective observational study of 138 patients. J Thorac Dis. 2013;5(3):228-233.
  • 21. Nadir A, Kaptanoğlu M, Gönlügür U, et al. Bronsektazinin cerrahi tedavisi: 36-olgunun değerlendirilmesi. T Klin J Med Sci. 2003:23(1):359-365.
  • 22. Gursoy S, Ozturk AA, Ucvet A, Erbaycu AE. Surgical management of bronchiectasis: the indications and outcomes. Surg Today 2010;40(1):26-30.
  • 23. Fan LC, Liang S, Lu HW, Fei K, Xu JF. Efficiency and safety of surgical intervention to patients with Non- Cystic Fibrosis bronchiectasis: a meta-analysis. Sci Rep. 2015;5(1):17382.
There are 23 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Erkan Akar 0000-0002-9113-8237

Miktat Arif Haberal 0000-0002-1051-094X

Project Number yok
Publication Date August 25, 2021
Published in Issue Year 2021 Volume: 5 Issue: 2

Cite

APA Akar, E., & Haberal, M. A. (2021). Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases. Ahi Evran Medical Journal, 5(2), 140-145. https://doi.org/10.46332/aemj.827315
AMA Akar E, Haberal MA. Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases. Ahi Evran Med J. August 2021;5(2):140-145. doi:10.46332/aemj.827315
Chicago Akar, Erkan, and Miktat Arif Haberal. “Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases”. Ahi Evran Medical Journal 5, no. 2 (August 2021): 140-45. https://doi.org/10.46332/aemj.827315.
EndNote Akar E, Haberal MA (August 1, 2021) Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases. Ahi Evran Medical Journal 5 2 140–145.
IEEE E. Akar and M. A. Haberal, “Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases”, Ahi Evran Med J, vol. 5, no. 2, pp. 140–145, 2021, doi: 10.46332/aemj.827315.
ISNAD Akar, Erkan - Haberal, Miktat Arif. “Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases”. Ahi Evran Medical Journal 5/2 (August 2021), 140-145. https://doi.org/10.46332/aemj.827315.
JAMA Akar E, Haberal MA. Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases. Ahi Evran Med J. 2021;5:140–145.
MLA Akar, Erkan and Miktat Arif Haberal. “Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases”. Ahi Evran Medical Journal, vol. 5, no. 2, 2021, pp. 140-5, doi:10.46332/aemj.827315.
Vancouver Akar E, Haberal MA. Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases. Ahi Evran Med J. 2021;5(2):140-5.
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