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Ann Thorac Surg 2003;75:382-387
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Limited operation for severe multisegmental bilateral bronchiectasis

^a Department of Pulmonary Diseases, Rangueil Hospital, University of Toulouse, Toulouse, France
^b Department of Radiology, Purpan Hospital, University of Toulouse, Toulouse, France
^c Department of Thoracic Surgery, Purpan Hospital, University of Toulouse, Toulouse, France

Accepted for publication August 24, 2002.

* Address reprint requests to Dr Mazières, Service de Pneumologie, Centre Hôpitalier Universitaire Rangueil, 1 avenue Jean Poulhes, 31403 Toulouse, France
e-mail: mazieres.j{at}chu-toulouse.fr

BACKGROUND: Some patients exhibiting severe multisegmental bilateral bronchiectasis are no longer improved with antibiotic treatment and drainage and, most of the time, operation is contraindicated. In our institution, limited operation has been offered to select patients for this indication. We report our data regarding the feasibility and utility of such a procedure.

METHODS: We studied 16 patients who underwent surgical removal of nonlocalized disease between 1990 and 1999. We report the mortality and morbidity rates of this surgical procedure and the clinical, bacteriological, and functional data for each patient.

RESULTS: There was no mortality and the morbidity was low (18%, all with favorable outcome). Symptoms such as hemoptysis, sputum production, or dyspnea were also improved. The recurring infections decreased in frequency in 8 patients and disappeared completely in 5 others. The bacteriological data assessment revealed disappearance of germs in 4 patients and persistence of chronic colonization in others. Postoperative spirometric data were not worsened and postoperative computed tomographic scans did not show progression of lesions not removed.

CONCLUSIONS: These results suggest that, in properly selected patients, lasting symptomatic improvement can be achieved by resection. Limited operation may be indicated in nonlocalized bilateral bronchiectasis, provided that a target can be identified. This procedure is supported by physiopathologic arguments and is particularly relevant to patients with bronchiectasis with cystic and functionless territories.

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