Surgical treatment of bronchiectasis: A review of 20 years of experience

Coutinho, Daniel; Fernandes, Pedro; Guerra, Marina Prista; Miranda, José; Vouga, Luís

doi:10.1016/j.rppnen.2015.09.007

Cited by 13 publications

(11 citation statements)

References 13 publications

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“…A meta-analysis revealed a mortality rate of 1.5% and an improvement in symptoms in 66.5% of patients 145 . In one study, quality of life after 1 year of follow-up was reported as excellent in 73.3% of patients and as unchanged in only 8.3% 150 . One group of authors also demonstrated that quality of life improved and exercise capacity was preserved in selected surgical patients 151 .…”

Section: Therapeutic Management Of Stable Patientsmentioning

confidence: 99%

Brazilian consensus on non-cystic fibrosis bronchiectasis

et al. 2019

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Bronchiectasis is a condition that has been increasingly diagnosed by chest HRCT. In the literature, bronchiectasis is divided into bronchiectasis secondary to cystic fibrosis and bronchiectasis not associated with cystic fibrosis, which is termed non-cystic fibrosis bronchiectasis. Many causes can lead to the development of bronchiectasis, and patients usually have chronic airway symptoms, recurrent infections, and CT abnormalities consistent with the condition. The first international guideline on the diagnosis and treatment of non-cystic fibrosis bronchiectasis was published in 2010. In Brazil, this is the first review document aimed at systematizing the knowledge that has been accumulated on the subject to date. Because there is insufficient evidence on which to base recommendations for various treatment topics, here the decision was made to prepare an expert consensus document. The Brazilian Thoracic Association Committee on Respiratory Infections summoned 10 pulmonologists with expertise in bronchiectasis in Brazil to conduct a critical assessment of the available scientific evidence and international guidelines, as well as to identify aspects that are relevant to the understanding of the heterogeneity of bronchiectasis and to its diagnostic and therapeutic management. Five broad topics were established (pathophysiology, diagnosis, monitoring of stable patients, treatment of stable patients, and management of exacerbations). After this subdivision, the topics were distributed among the authors, who conducted a nonsystematic review of the literature, giving priority to major publications in the specific areas, including original articles, review articles, and systematic reviews. The authors reviewed and commented on all topics, producing a single final document that was approved by consensus.

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Section: Therapeutic Management Of Stable Patientsmentioning

confidence: 99%

Brazilian consensus on non-cystic fibrosis bronchiectasis

et al. 2019

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“…Advances in the medical management of bronchiectasis have made surgical intervention less common. However, in the case of highly-localized disease, resection of affected lobes can improve a patient's QOL and reduce the frequency of antibiotic courses (99,100). Indication for surgical resection of an affected lobe of the lung include persistent failure of medical management and hemoptysis, and current expert consensus recommends limiting lobectomy to those patients in whom maximal medical management has been trialed (61,100).…”

Section: Surgical Managementmentioning

confidence: 99%

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

2020

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Bronchiectasis, the presence of bronchial wall thickening with airway dilatation, is a particularly challenging complication of primary antibody deficiencies. While susceptibility to infections may be the primary factor leading to the development of bronchiectasis in these patients, the condition may develop in the absence of known infections. Once bronchiectasis is present, the lungs are subject to a progressive cycle involving both infectious and non-infectious factors. If bronchiectasis is not identified or not managed appropriately, the cycle proceeds unchecked and yields advanced and permanent lung damage. Severe symptoms may limit exercise tolerance, require frequent hospitalizations, profoundly impair quality of life (QOL), and lead to early death. This review article focuses on the appropriate identification and management of bronchiectasis in patients with primary antibody deficiencies. The underlying immune deficiency and the bronchiectasis need to be treated from combined immunology and pulmonary perspectives, reflected in this review by experts from both fields. An aggressive multidisciplinary approach may reduce exacerbations and slow the progression of permanent lung damage.

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“…2 In patients with localised disease, recent reviews suggest that the removal of the permanently damaged areas of the lung can result in significant symptom resolution and an improved quality of life. 75, 76 In a meta-analysis of 38 studies covering 5541 patients who had surgical resection for management of bronchiectasis, operative morbidity and mortality rates were 16.7% and 1.5%, respectively. 76 …”

Section: Overall Goals Of Treatmentmentioning

confidence: 99%

Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults

Chalmers

Sethi

2017

npj Prim Care Resp Med

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Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.

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Surgical treatment of bronchiectasis: A review of 20 years of experience

Abstract: Although the number of patients with bronchiectasis referred for surgical treatment has decreased, pulmonary resection still plays a significant role. Surgical resection of localized bronchiectasis is a safe procedure with proven improvement of quality of life for the majority of patients.

Cited by 13 publications

References 13 publications

Brazilian consensus on non-cystic fibrosis bronchiectasis

Brazilian consensus on non-cystic fibrosis bronchiectasis

Bronchiectasis in Primary Antibody Deficiencies: A Multidisciplinary Approach

Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults

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