Bronşektazide cerrahi tedavi: Klinik özellikler ve uzun dönem sonuçlar
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Dosyalar
Tarih
2014
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada bronşektazili hastaların klinik özellikleri belirlendi ve cerrahinin uzun dönem sonuçları değerlendirildi.Çalışma planı: Ocak 2001 - Haziran 2011 tarihleri arasında, İstanbul Üniversitesi İstanbul Tıp Fakültesi Göğüs Cerrahisi Kliniği'nde cerrahi rezeksiyon uygulanan 39 (23 erkek, 16 kadın; ort. yaş 25.6 yıl; dağılım 5-63 yıl) bronşektazi hastasının tıbbi kayıtları retrospektif olarak incelendi. Uzun dönem sonuçlar için hastalara mektup, telefon veya poliklinik kontrolleri ile ulaşıldı. Hastalar yaş, cinsiyet, etyolojik faktörler, semptomlar, tanı yöntemleri, lezyonun yerleşim yeri, yapılan ameliyat, morbidite, hastanede kalış süresi ve uzun dönem sonuçlar açısından değerlendirildi.Bul gu lar: En sık görülen semptom öksürük ve balgam çıkarma, en sık etyolojik faktör çocukluk çağından bu yana geçirilen enfeksiyonlar idi. Yirmi iki hastada (%56) sol akciğer tutulumu, 11 hastada (%28) sağ akciğer tutulumu ve altı hastada (%15) iki taraflı akciğer tutulumu vardı. On altı hastada (%41) birden çok lob tutulumu ve 23 hastada (%59) tek lob tutulumu vardı. Bronşektazinin en sık etkilediği alan, 13 hasta (%33) ile sol alt lob idi. Otuz bir hastada (%80) tam rezeksiyon, sekiz hastada (%20) tam olmayan rezeksiyon uygulandı. Uzun dönem sonuçlarına ulaşılabilen 33 hastadan 22'sinde (%67) tam şifa, dokuzunda (%27) klinik semptomlarda iyileşme ve ikisinde (%6) başarısızlık saptandı. Tam şifa ve kısmi şifa oranları, tam rezeksiyon uygulanan hastalarda sırası ile %73 ve %23 iken, tam olmayan rezeksiyon uygulanan hastalarda sırası ile %43 ve %43 olarak saptandı.So nuç: Bronşektazi hastalarında cerrahi tedavi %90'ın üzerinde başarı oranı ile iyi bir tedavi seçeneğidir. Tam rezeksiyon daha iyi uzun dönem sonuçlara sahiptir. Ancak tam rezeksiyon için uygun olmayan hastalarda tam olmayan rezeksiyon yapılabilir.
Background: This study aims to determine the clinical characteristics of the patients with bronchiectasis and evaluate the long-term outcomes of surgery. Methods: Medical records of 39 patients (23 males and 16 females; mean age 25.6 years; range, 5 to 63 years) with bronchiectasis who underwent surgical resection at Istanbul University, Istanbul Medical Faculty, Thoracic Surgery Department between January 2001 and June 2011 were retrospectively reviewed. Long-term follow-up data of the patients were obtained by the letter, telephone or outpatient control visits. Patients were evaluated according to the age, sex, etiological factors, symptoms, diagnostic methods, localization of lesion, surgery performed, morbidity, duration of hospital stay and long-term outcomes. Results: The most frequent symptoms were cough and sputum, while the most frequent etiological factor was having infections since childhood era. Twenty-two patients (56%) had left lung involvement, 11 patients (28%) had right lung involvement, and six patients (15%) had bilateral lung involvement. There were multiple lobe involvement in 16 patients (41%) and single lobe involvement in 23 patients (59%). The most affected region by bronchiectasis was the left lower lobe in 13 patients (33%). Complete resection was applied to 31 patients (80%), while incomplete resection was applied to eight patients (20%). From 33 patients of whose follow-up data were obtained, 22 (67%) were completely recovered, nine (27%) had improved clinical symptoms, and in two (6%) treatment failed. Complete and partial recovery ratios were 73% and 23% in patients undergoing complete resection, respectively and 43% and 43% in patients undergoing incomplete resection, respectively. Conclusion: In patients of bronchiectasis, surgical resection is a good treatment option with a success rate more than 90%. Complete resection has better long-term outcomes. However, incomplete resection can be also applied to the patients who are ineligible for complete resection.
Background: This study aims to determine the clinical characteristics of the patients with bronchiectasis and evaluate the long-term outcomes of surgery. Methods: Medical records of 39 patients (23 males and 16 females; mean age 25.6 years; range, 5 to 63 years) with bronchiectasis who underwent surgical resection at Istanbul University, Istanbul Medical Faculty, Thoracic Surgery Department between January 2001 and June 2011 were retrospectively reviewed. Long-term follow-up data of the patients were obtained by the letter, telephone or outpatient control visits. Patients were evaluated according to the age, sex, etiological factors, symptoms, diagnostic methods, localization of lesion, surgery performed, morbidity, duration of hospital stay and long-term outcomes. Results: The most frequent symptoms were cough and sputum, while the most frequent etiological factor was having infections since childhood era. Twenty-two patients (56%) had left lung involvement, 11 patients (28%) had right lung involvement, and six patients (15%) had bilateral lung involvement. There were multiple lobe involvement in 16 patients (41%) and single lobe involvement in 23 patients (59%). The most affected region by bronchiectasis was the left lower lobe in 13 patients (33%). Complete resection was applied to 31 patients (80%), while incomplete resection was applied to eight patients (20%). From 33 patients of whose follow-up data were obtained, 22 (67%) were completely recovered, nine (27%) had improved clinical symptoms, and in two (6%) treatment failed. Complete and partial recovery ratios were 73% and 23% in patients undergoing complete resection, respectively and 43% and 43% in patients undergoing incomplete resection, respectively. Conclusion: In patients of bronchiectasis, surgical resection is a good treatment option with a success rate more than 90%. Complete resection has better long-term outcomes. However, incomplete resection can be also applied to the patients who are ineligible for complete resection.
Açıklama
Anahtar Kelimeler
Bronchiectasis, Surgical Resection, Long-term outcame
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
Turkish Journal Of Thoracic And Cardiovascular Surgery
Turkish Journal Of Thoracic And Cardiovascular Surgery
WoS Q Değeri
Scopus Q Değeri
Cilt
22
Sayı
3
