Surgical Treatment of Bronchiectasis: A Retrospective Analysis of 790 Patients
Surgical Treatment of Bronchiectasis: A Retrospective Analysis of 790 Patients
复制标题
支气管扩张症的手术治疗：790 例患者的回顾性分析
DOI：
10.1016/j.athoracsur.2010.03.064
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发表时间：
2010-07-01
影响因子：
4.6
通讯作者：
Zhou, Xiao
中科院分区：
文献类型：
--
作者：
Zhang, Peng;Jiang, Gening;Zhou, Xiao
背景。支气管扩张症的全球发病率不断上升，该病在中国农村流行。本研究调查了中国一家机构的支气管扩张手术的手术死亡率、发病率和结果。方法。我们回顾性回顾了1989年1月至2008年12月期间在我科连续接受支气管扩张手术的790例患者的病历。局限性支气管扩张通过高分辨率计算机断层扫描诊断。非手术治疗失败后症状持续存在是手术的指征。囊性纤维化患者被排除在本研究之外。结果。研究样本包括 790 名患者（466 名男性，324 名女性），他们因支气管扩张接受了 810 次手术。手术时的平均年龄为 41.6 岁（范围为 6 至 79 岁）。使用了几种外科手术：肺叶切除术（497例；62.9%）、肺段切除术（37例；4.7%）、全肺切除术（90例；11.3%）、双肺叶切除术（56例；7.1%）以及肺叶切除术和肺段切除术（110例；14.0%）。无术中死亡。九名（1.1%）患者在术后死亡。单变量分析显示高龄（p = 0.04）和肾衰竭（p = 0.001）与术后死亡率相关，多变量分析显示术前肾衰竭与死亡率相关（p = 0.025）。平均随访时间为 4.2 年（范围：10 个月至 10 年）。术后，478例（60.5%）患者无症状，111例（14.1%）病情好转，117例（14.8%）病情无改善或恶化。结论。局部支气管扩张通常是手术切除的指征，这是一种安全的手术，具有可接受的手术发病率、死亡率和结果。 （Ann Thorac Surg 2010；90:246-51） (C) 2010，胸外科医师协会
Background. The global incidence of bronchiectasis is increasing, and this disease is prevalent in rural China. This study examined operative mortality, morbidity, and outcomes of surgery for bronchiectasis at a single institution in China.Methods. We retrospectively reviewed the medical records of 790 consecutive patients who underwent surgery for bronchiectasis in our department between January 1989 and December 2008. Localized bronchiectasis was diagnosed by high-resolution computed tomography. The persistence of symptoms after failure of nonsurgical treatment was an indication for surgery. Cystic fibrosis patients were excluded from this study.Results. The study sample included 790 patients (466 male, 324 female) who underwent 810 operations for bronchiectasis. Mean age at time of surgery was 41.6 years (range, 6 to 79 years). Several surgical procedures were used: lobectomy (497; 62.9%), segment resection (37; 4.7%), pneumonectomy (90; 11.3%), bilobectomy (56; 7.1%), and lobectomy and segmentectomy (110; 14.0%). There were no intraoperative deaths. Nine (1.1%) patients died in the postoperative period. Univariate analysis showed that advanced age (p = 0.04) and renal failure (p = 0.001) were associated with postoperative mortality, and multivariate analysis revealed that preoperative renal failure was associated with mortality (p = 0.025). The mean follow-up time was 4.2 years (range, 10 months to 10 years). After surgery, 478 (60.5%) patients were asymptomatic, 111 (14.1%) had improved, and 117 (14.8%) showed no improvement or worsened condition.Conclusions. Localized bronchiectasis is usually the indication for surgical resection, which is a safe procedure with acceptable operative morbidity, mortality, and outcomes. (Ann Thorac Surg 2010;90:246-51) (C) 2010 by The Society of Thoracic Surgeons