Results of bronchiectasis surgery: About 64 cases

Introduction. - Bronchiectasis is a serious and disabling disease. Surgical treatment is an interesting alternative to be proposed early to patients in case of complications or deterioration of quality of life, despite an optimal medical treatment. Through this retrospective study and literature review, we analyze surgical results for bronchiectasis: Patients and method. - We conducted a monocentric, retrospective, descriptive and analytical study in the Department of thoracic surgery of CHU Hassan II Fes, about 64 patients operated for bronchiectasis during the period from January 2009 to December 2016. Results. - There were 30 men and 34 women with an average age of 32 year,s. Twenty six percent (26%) had a history of recurrent lung infection, and 17.18% would have been treated for pulmonary tuberculosis and declared cured. Productive cough (93%), morning chronic bronchorrhea (92%) and repeatedly hemoptysis (62.5%) were the main symptoms. On CT scanning, the bronchiectasis was unilateral and localized in 49 cases. The right lung was involved in 27 cases and the location was bilateral in 15 cases. It was 38 cystic bronchiectasis, 16 cylindrical bronchiectasis, and 10 mixed lesions predominantly cylindrical. The flexible bronchoscopy carried out in 34 cases, had shown a carcinoid tumor in 1 case, a bronchiolithiasis in 1 case and a intrabronchial foreign body in 1 case. The incision was a conservative posterolateral thoracotomy in all cases. The performed surgical procedure was lobectomy in 53% of patients. The morbidity rate was 32.80% and dominated by septic complications. After a mean follow-up of 20.52 months, 2 cases of recurrence minimal hemoptysis and 1 case of renewed bronchorrhea are noted. For all other patients the outcome was favorable and no deaths have been noted to date. Conclusion. - The surgery of bronchiectasis requires a perfect collaboration between the pulmonologist, the thoracic surgeon, the anesthesiologist, the biologist and particularly the physiotherapist for an optimal care of patients. (C) 2017 Elsevier Masson SAS. All rights reserved.