The surgical treatment of lung bronchiectasis

Abstract

For the last 20 years we treated 372 patients with bronchiectasis, men - 182, women - 190. The average age was 32.5±1.5 years. More often damaged lower lobe on the left - 168, middle – 94, lower lobe on the right - 90, lingual segments - 64. The unilateral plural defeats observed in 198 patients. Zivert-Kartagener's syndrome was diagnosed in 12 cases. 54 patients earlier underwent different operative interventions: pneumonectomy - 6, lobectomy on the right - 20, on the left - 10, resection of lingual segments - 12, transverse resection - 6.

MSCT allows to study the nature of the lung defeat detally. Deformation of bronchi is revealed in 66 patients, cylindrical bronchiectases in 122, saccular bronchiectases in 112, cystic bronchial expansion in 50, narrowing of lobular bronchus in 2, pneumocirrosis in 44 patients and mixed bronchiectases in 32 cases.

In 228 patients was noted presence of the wide-spread non-operable forms of the defeat, after complex therapy they were discharged on dispensary observation. 144 patients underwent operations: in 86 events is made resection of damaged lobe, pneumonectomy - 14, bilobectomy - 15, transverse resection - 22, resection of lingual segments - 6, marginal resection in 2 patient, in 3 events was made embolization of bronchial artery for stopping the pulmonary bleeding.

The postoperative period was complicated in 12 cases by empyema pleura with bronchial fistula, ligature fistula - 6, athelectasis of remained part of lung - 3, suppuration of operating wound - in 7, intrapleural bleeding - in 4 cases. Intrapleural bleedings was stoped by rethoracotomy, in rest events complications were liquidated conservatively. The lethal outcome observed in 2 (1,38%) cases.