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J Thorac Cardiovasc Surg 2007;134:392-398
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Risk factors affecting outcome and morbidity in the surgical management of bronchiectasis

^a Department of Thoracic Surgery, Dicle University, School of Medicine, Diyarbakir, Turkey
^b Department of Thoracic Surgery, Kocatepe University, School of Medicine, Afyon, Turkey.

Received for publication December 15, 2006; revisions received April 2, 2007; accepted for publication April 11, 2007.

^_* Address for reprints: Sevval Eren, MD, Dicle University School of Medicine, Department of Thoracic Surgery, 21280 Diyarbakir, Turkey. (Email: sevval{at}dicle.edu.tr).

Objective: Bronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study was to present the results of our 14 years of surgical experience to re-evaluate our indications for using surgical therapy and to analyze several factors that might affect the outcome and postoperative complications of this disease.

Method: Age, sex, etiologic factors, symptoms, the duration of symptoms, radiologic and radionuclide examinations, preoperative evaluation, surgical procedures, postoperative morbidity and mortality, and the follow-up results from 143 patients operated on for bronchiectasis between January 1992 and January 2006, were reviewed retrospectively.

Results: One hundred forty-three patients underwent 148 operations for bronchiectasis. The mean age was 23.4 years. Complete resection was achieved in 118 patients. The morbidity rate was 23.0% and the mortality rate was 1.3%. Postoperatively, 75.9% of the patients were free of symptoms, 15.7% were improved, and 8.2% showed no improvement or were worse. The logistic regression analysis showed that a history of tuberculosis and incomplete resection were independent predictors of the operative result. Moreover, the lack of a preoperative bronchoscopic examination, a forced expiratory volume in 1 second of less than 60% of the predicted value, a history of tuberculosis, and incomplete resection were independent predictors of postoperative complications.

Conclusions: A history of tuberculosis and incomplete resection were risk factors both for postoperative complications and for a worse operative result. The lack of a preoperative bronchoscopic examination and a low forced expiratory volume in 1 second were risk factors for postoperative complications. Surgery for multiple segments on different lobes should be performed whenever possible.

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