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

J Thorac Cardiovasc Surg. 2007 Aug;134(2):392-8. doi: 10.1016/j.jtcvs.2007.04.024.


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.

MeSH terms

  • Adolescent
  • Adult
  • Bronchiectasis / diagnostic imaging
  • Bronchiectasis / mortality
  • Bronchiectasis / surgery*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prognosis
  • Radiography
  • Radionuclide Imaging
  • Respiratory Function Tests
  • Risk Factors
  • Survival Rate
  • Thoracotomy
  • Treatment Outcome