Surgical Outcome of Bronchiectasis in Children: Long Term Results of 60 Cases

Abstract

Background: Bronchiectasis is described as destruction and the irreversible dilatation of bronchial structure. We wanted to demonstrate our surgical practice and outcome of surgical treatment in bronchiectasis.

Methods: We studied records of 60 pediatric patients who underwent surgical resection in our clinic between January 2000 and January 2013. The results were analyzed regarding factors influencing the outcome.

Results: There were 32 boys and 28 girls with a mean age of 9.45 years (range 2–15). The most common cause was childhood infection in 25 (41.66%). The mean duration of the symptoms was 42.93 months. Patients underwent 64 operations including 2 staged thoracotomies and 2 re-thoracotomies. Atelectasis was the most frequent complication. Longer duration of symptoms related to postoperative complication. The morbidity and mortality rates were 20% and 3.33%, respectively. The outcome was optimal in 92%. Forced expiratory volume in 1 s less than 60% of the predicted value, hemoptysis and duration of symptoms were found prognostic variables for postoperative morbidity with high ratios of odds coefficients by using Binary Logistic Regression Method.

Conclusions: Complete and early resection of bronchiectasis provides a successful outcome. Duration of symptoms and timely intervention have a major impact on the management and prognosis.

Zusammenfassung

Hintergrund: Bronchiektasen sind durch eine irreversible Dilatation und Strukturzerstörung der Bronchialwand definiert. Wir wollen unser chirurgisches Vorgehen und Langzeitergebnisse präsentieren.

Patienten & Methodik: Wir untersuchten Datensätze von 60 pädiatrischen Patienten, die von Jänner 2000 bis 2013 einer chirurgische Resektion an unserer Klinik unterzogen worden waren. Wir evaluierten mehrere Variablen und deren Einfluss auf das postoperative Ergebnis.

Ergebnisse: 32 Jungen und 28 Mädchen mit einem Durchschnittsalter von 9,45 Jahren (zwischen 2–15) wurden operiert. Die häufigste Ursache waren kindliche Infektionskrankheiten in 25 Fällen (42%). Die mittlere Dauer der Symptome betrug 43 Monate. Die Patienten wurden 64 Operationen, darunter 2 mehrzeitigen Thorakotomien und 2 Re-Thorakotomien unterzogen. Atelektasen waren die häufigste Komplikation. Die Symptomdauer korrelierte mit postoperativen Komplikationen. Die Morbidität und Mortalität waren 20% und 3,3%. Das Ergebnis wurde in 92% als optimal gewertet. Eine Einsekundenkapazität<60%, Hämoptysen und die Symptomdauer zeigten einen Zusammenhang zum postoperativen Ergebnis (erhöhte Odds Ratios in einer binären Regressionsanalyse).

Schlussfolgerungen: Eine möglichst frühzeitige und komplette Bronchiektasenresektion führt zu guten Ergebnissen. Symptomdauer und zeitgerechte Intervention sind für Management und Prognose wichtig.

Key words

childhood - bronchiectasis - surgery - management

Schlüsselwörter

Kindheit - Bronchiektasen - Chirurgie - Management

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