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Lung diseases

Bronchiectasis - Surgery

05/24/2004

Question:

I`m 42 and have congenital bronchiectasis. I was advised by a doctor to undergo surgery on my right lower lung lobe due to repeated infections and it`s cystic. I would like to get your second opinion if undergo such surgery will cure my bronchiectasis. Thank you

Answer:

There are many causes for bronchiectasis. Before considering surgery, it is important to understand the cause of the bronchiectasis. For example, cystic fibrosis, ciliary dyskinesis and a variety of infections are associated with a progressive bronchiectasis. Removal of a lobe in one of these diseases may not prevent progression and may cause more harm than good. There are instances when removal of an affected area may prevent recurrent illness due to infection in the area of bronchiectasis. In the correct circumstances, surgery can give a dramatic improvement, but it can compound problems if done in the wrong setting. The decision to remove the area should be made carefully and with much consideration. Before surgery, carefully consider such factors as how often and how severe the infections are, whether the area involved is confined to a single area or involves multiple lobes, what bacteria infect the area of bronchiectasis, and whether there are other underlying causes. It is important to look for unusual infections such as atypical mycobacterium. Evaluation for cystic fibrosis, ciliary dyskinesia, and IgA deficiency should be seriously considered. A CT scan of the chest to evaluate the extent of bronchiectasis is essential. In short, be certain that this is congenital, not associated with another disease process before proceeding. If there is still concern or uncertainty, a second opinion from a pulmonologist may help clarify the question.

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Response by:

Patricia   Joseph, MS, MD Patricia Joseph, MS, MD
Associate Professor of Medicine
College of Medicine
University of Cincinnati