Bronşektazi Cerrahisinin Uzun Dönem Sonuçları;108 Olgu

Amaç: Cerrahi rezeksiyon uygulayıp uzun süre takip ettiğimiz olguların sonuçlarını değerlendirmeyi amaçladık.Araçlar ve Yöntem: 2005 ile 2019 tarihler arasında kliniğimize başvuran, bronşektazi tanısı alan ve opere edilen 108 hastanın dosyaları (38 erkek, 70 kadın; ortalama yaş 23.03 yıl (18-63)) geriye dönük olarak değerlendirildi. Ameliyat sonrası hastaların takipleri; akciğer grafisi, SFT, tam kan, CRP takibi ve ameliyat öncesi şikâyetleri (öksürük, balgam çıkarma, tekrarlayan akciğer enfeksiyonları) sorgulanıp kaydedildi. Hastaları ameliyat sonrası değerlendirirken, ameliyat öncesi şikâyetlerin olmaması, şikâyetlerin azalması ve değişiklik olmaması şeklinde kategorize edildi.Bulgular: Yüz sekiz hastaya 115 cerrahi işlem yapıldı. Cerrahi sonrası en fazla görülen komplikasyon atelektazi ve uzamış hava kaçağı idi. Cerrahi olarak çoğunlukla lobektomi uygulandı. Postoperatif morbidite 44 hasta ile %41 idi. Mortalite ise 5 hasta ile %5 idi. Tam düzelme 87 hasta (%81), 15 hasta da (%14) ise şikâyetleri kabul edilebilir düzeyde ve antibiyotik kullanma gereksinimi vardı. Altı hastada (%5) ise başka lobda nüks etti. Hastalarımızın ortalama takip süresi 3.71 yıl (8 ay-12 yıl) idi. Sonuç: Uygun olarak tedavi edilmeyen bronşektazi hastaları enfeksiyonların kısır döngüsü ile seyreder. Cerrahi tedaviyi gerektiren risk faktörleri morbiditeyi de belirler. Etkilenen dokuların cerrahi rezeksiyonu ile bu kısır döngü sonlandırılabilir.

Anahtar Kelimeler:

bronşektazi, komplikasyon, postoperatif, rezeksiyon

Long-Term Outcomes of Bronchiectasis Surgery: 108 Cases

Purpose: We aimed to analyze the cases that we monitored for long term after applying surgical resection.Materials and Methods: Admitted to our clinic between 2005 and 2019, the files of 108 patients (38 male, 70 female, mean age of 23.03 years (18-63)), who visited our clinic, were diagnosed with bronchiectasis and operated on, were retrospectively analyzed. For the monitoring of the patients after surgery, chest radiography, PFT, CBC and CRP follow-up results, and their preoperative complaints (coughing, expectoration, recurrent pulmonary infections) were examined and recorded. While assessing the patients’ status after the surgery, they were categorized as disappearance of the preoperative complaints, decrease in the complaints, and no change in the complaints.Results: 115 surgical operations were carried out on 108 patients. The most frequently encountered complications after surgery were atelectasis and prolonged air leak. Mostly lobectomy was applied as surgery. Postoperative morbidity was seen in 44 patients (41%). Mortality was seen in 5 patients (5%). Complete recovery was observed in 87 patients (81%), while the complaints of 15 patients (14%) were on an acceptable level, and they needed to use antibiotics. The disease relapsed in another lobe in 6 patients (5%). The mean time of monitoring among our patients was 3.71 years (8 months - 12 years).Conclusion: Infections fall into a vicious circle in bronchiectasis patients who are not appropriately treated. The risk factors that require surgery determine morbidity. This cycle may be ended by the surgical resection of the affected tissues.

Keywords:

bronchiectasis, complication, postoperative, resection,

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