Surgical treatment of bronchiectasis.

In recent years several reports have suggested that pulmonary resection is the treatment of choice in selected cases of primary bronchiectasis. In this study the clinical features and results of surgical treatment in 53 cases of primary bronchiectasis are described.     

Surgical treatment of bronchiectasis in Kartagener's syndrome.

A case of Kartagener's syndrome in which bilateral partial pulmonary resection was performed is reported. The literature concerning the surgical treatment of severe bronchiectasis is reviewed.     

儿童陈旧性Tile C型骨盆环损伤的手术治疗

目的探讨儿童陈旧性Tile C型骨盆环损伤的治疗方法。方法对6例儿童陈旧性Tile C型骨盆环损伤采用扩大的髂腹股沟入路进行骨盆前后环损伤部松解或截骨，术后股骨髁上持续大重量牵引6周治疗。结果骨盆复位参照Mears等评定标准，复位满意5例，复位不满意1例。随访时间6个月～3年，平均1年10个月。5例行走正常，无跛行及疼痛；1例轻度跛行，偶感腰臀痛，但较术前畸形明显好转。无手术并发症。结论采用骨盆前、后环损伤部松解或截骨及术后股骨髁上持续大重量牵引治疗儿童陈旧性Tile C骨盆环损伤是一种安全、可行的治疗方法。     

联合手术方法治疗儿童先天性马蹄内翻足

目的探讨联合手术方法治疗小儿先天性马蹄内翻足。方法18例33足先天性马蹄内翻足患儿。采用联合手术方法包括跟腱冠状位延长、胫前肌移位、足内侧短缩软组织切开、跖筋膜切断和骰骨内“V”形截骨。结果14例25足获得随访。随访时间6～18月,平均7月。优良13例24足,1例1足手术效果差。结论联合手术方法治疗儿童先天性马蹄内翻足具有减少手术次数、短期无复发的优点。     

手术治疗18例儿童干骺端骨囊肿

目的探讨病灶刮除、同种异体骨植骨、锁定钛板内固定术治疗儿童干骺端骨囊肿的临床疗效。方法对18例干骺端骨囊肿患儿均采用病灶刮除、无水乙醇囊肿壁组织灭活、同种异体骨植骨、锁定板内固定治疗。结果 18例患儿均获得随访,时间11～34个月。患儿均无患肢疼痛及功能障碍,无复发。结论切开病灶刮除、同种异体骨植骨、锁定钛板内固定治疗儿童干骺端骨囊肿疗效较好。     

Lung transplantation for non-cystic fibrosis bronchiectasis in Turkey: An initial institutional experience

Background/objectiveLung transplantation is a well-established treatment in patients who have bronchiectasis with diffuse involvement, and with a progressive decline in respiratory function despite maximal medical therapy. We have aimed to present pre-transplantation factors and our results of lung transplantation for non-cystic fibrosis bronchiectasis.MethodsPatients who underwent lung transplantation for non-cystic fibrosis bronchiectasis between the dates of December 2016 and July 2019 were included. The patients' clinical parameters, pulmonary function tests, microbiological results, cardiac parameters, intraoperative data, and lung transplant outcomes were assessed retrospectively.ResultsBilateral lung transplantation for bronchiectasis were performed in eleven patients. The mean age was 36.5 years (range 22–57 years). There were 4 (36.4%) female patients and 7 (63.6%) male patients. All patients had a high score as per the bronchiectasis severity index (BSI). The FACED score was moderate in six patients and severe in five patients. Preoperative colonization with Pseudomonas aeruginosa was observed in five patients. Hospital mortality was 18.2% (2/11). The 1-year mortality was 27.2% (3/11). Eight patients were alive. The mean follow-up period of patients with survival was 28.2 months (range 13–42 months). One patient was diagnosed with chronic lung allograft dysfunction (CLAD). The 3-year survival rates were 73%.ConclusionLung transplantation for bronchiectasis with end-stage lung disease can improve the quality of life and increase survival in selected patients. Further studies are needed to identify the optimal time for lung transplantation referral due to the availability of limited data.     

臀肌挛缩症的手术治疗

臀肌挛缩症导致髋关节功能障碍,多见于儿童,其手术方法有多种。1982年6月~2002年11月,我院共收治31例,采用不同手术方法治疗,术后功能恢复较满意。1材料与方法1.1病例资料本组31例,男19例,女12例,年龄2~12岁。单侧5例,双侧26例。其中28例有多次臀肌注射史。患儿多因步态异常或双下肢不能下蹲,坐位时两下肢不能交叉而就诊。1.2临床表现患儿多呈外“八”字步态,快走不稳,呈跳跃式,髋关节活动有弹响或有下蹲障碍,坐位时双膝不能并拢,下蹲时双髋关节可呈现蛙腿征,臀部触及发现单侧或双侧臀肌萎缩及沿臀肌方向上条索状块。1.3治疗方法均采取手术…     

Surgical treatment of "minor" forms of bronchiectasis

A total of 835 operations were conducted for bronchiectasis on 734 patients (75.9% were children and adolescents). The late-term results of operations for "minor" forms of the disease in 118 patients are discussed. The increase of the proportion of "minor" forms in the structure of bronchiectasis calls for changes of the tactics with prevalence of segmental and polysegmental lung resections. The relative number of the last named has been constantly growing in the recent 2 decades. The methods for determining the volume of the operation in bronchiectasis must be improved. All patients who underwent operation for "minor" forms of bronchiectasis must be kept under dynamic observation and more than half of them must be given regular anti-recurrence treatment for some years.     

Surgical treatment in bronchiectasis: analysis of 166 patients.

BACKGROUND: Bronchiectasis is usually caused by pulmonary infections and bronchial obstruction. It is still a serious problem in developing countries as our country. We reviewed the morbidity and mortality rates and outcome of surgical treatment for bronchiectasis. PATIENTS AND METHODS: Between 1990 and 2000, 166 patients (92 female and 74 male patients) underwent pulmonary resection for bronchiectasis. The mean age was 34.1 years (range, 7-70 years). Mean duration of symptoms was 5.7 years. RESULTS: Symptoms were copious amount of purulent sputum in 135 patients, expectoration of foul-smelling sputum in 109, hemoptysis in 35 and cough in all patients. The indication for pulmonary resection was failure of medical therapy in 158 patients, massive hemoptysis in five and lung abscess in three. The disease was bilateral in six patients and mainly confined to the lower lobe in 127. One hundred and twenty patients had a lobectomy, 13 had a pneumonectomy, 21 had a segmentectomy and a combination of these approaches in 18. Operative morbidity and mortality were seen in 18 (10.5%) and in three (1.7%) patients, respectively. Follow-up was complete in 148 patients with a mean of 4.2 years. Overall, 111 patients were asymptomatic after surgical treatment, symptoms were improved in 31, and unchanged or worse in six. CONCLUSIONS: Surgical treatment of bronchiectasis is more effective in patient with localized disease. It is satisfactory with acceptable ratio of morbidity and mortality.