Surgical treatment of bronchiectasis: a retrospective observational study of 260 patients

Abstract

Objective: This study aims to demonstrate our surgical experience for bronchiectasis and analyze the risk factors related with the surgery outcome.

Methods: We retrospectively reviewed medical records of 260 consecutive patients who underwent surgery for bronchiectasis between January 2000 and December 2010. The factors related with the outcome were analyzed and the candidate factors were screened by χ(2) test and t test. Furthermore, logistic regression analysis was used for multiple factor analysis to obtain the independent factors that affected the surgical outcome.

Results: Complications occurred in 30 (11.5%) patients during perioperative period. The univariate analysis showed that significant differences can be observed in age (P = 0.000), sputum volume (P = 0.000), smoking history (P = 0.033), pulmonary function (P = 0.003), Gram-negative bacillus infection (P = 0.000), bronchial stump coverage (P = 0.016) using intercostals muscles or pedicle pleura embedding and surgical approach (P = 0.003) between the patients with excellent and poor outcome. The multivariable analyses showed that sputum volume (P = 0.000), Gram-negative bacillus infection (P = 0.000) and bronchial stump coverage (P = 0.000) were the three independent factors related with surgical outcome.

Conclusion: Surgery is an effective treatment option for bronchiectasis. Sputum volumes lower than 30 mL, negative proof of Gram-negative bacteria and bronchial stump coverage using intercostals muscles or pedicle pleura embedding are the key factors for successful treatment. Special attention has to be given to any complications in elderly patients.

Keywords: Bronchiectasis; Multivariable analyses; Risk factors; Surgery; Univariate analyses.