Journal Title: تابستان 86
Article title: Results of the Surgical Treatment Versus Medical Treatment in a Group of Patients with Bronchiectasis

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Article abstract:
Introduction & Objective: Due to the recent advancement in the fields of antibiotic therapy, vaccination, and general health, there is a decreasing number of surgical interventions for the treatment of bronchiectasis. Considering the favorable advances in the field of lung surgery these days, it seems that physicians as well as patients are not acquainted with the surgical methods and the outcome of the surgical treatment of bronchiectasis. Therefore, we present and analyze our results in the surgical treatment of bronchiectasis and compare the results with medical treatment during the same period. Materials & Methods: The study population consisted of all patients who were referred to us (Masih Daneshvari Hospital) and hospitalized for the surgical treatment of bronchiectasis during 7.5 years (March 1999 to September 2006). Surgical or non-surgical treatment was selected according to the usual indications for the treatment of bronchiectasis. Response to treatment was evaluated by referring to the patients' medical records, and out-patient visits. The results were attributed as: Good: Sputum production and other major signs completely disappeared; Satisfactory: Although the signs and symptoms had not totally disappeared, the patient was satisfied with the treatment results; Poor: No significant changes were detected in the major signs and symptoms. Technique of surgery was posterolateral thoracotomy under one lung ventilation, and performing lobar or segmental resections. Medical treatment included physiotherapy, antibiotic administration and vaccination against influenza and pneumonococcus. Statistical analysis was performed by using Access and SPSS software. Fisher’s exact test and Chi-Square tests were used for qualitative comparison of the results. Mean duration of follow up was 35.9 months (range 1-96 months). Results: Total number of 83 patients were studied (48 females, 35 males, mean age 37.8 yrs, range 8-71), 40 patients underwent surgery while 43 underwent medical treatment. The results of surgery were: good in 16 (55.2%), satisfactory in 10 (34.5%) and poor in 2 (6.9%) patients. The results of medical treatment were good in 4 (13.8 %), satisfactory in 11 (37.9 %), and poor in 13 (44.8%) patients. Good results were significantly better (P=0.002) and poor results were significantly worse (P=0.002) after surgical treatment. In each group, one death occurred during the treatment course. Fourteen patients in medical group and 11 patients in surgical group were lost from follow up. Conclusions: When indicated, surgical therapy offers advantages over medical therapy in the treatment of bronchiectasis.
Article KeyWords:
Bronchiectasis, Treatment, Surgery
Article Authors:

	دكتر عـزيزالله عباسي	First Author	dezfouli@nritld.ac.ir
	دكتر شاهرخ ادهمي	Other Author
	سپهر عباسي	Other Author
	امير كسرائيان‌فرد	Other Author
	دكتر رويا فـرزانگان	Other Author