All are indications for surgery in bronchiectasis except:
Ans: C (Bilateral disease) Ref: Schwartz s Principles of Surgery: 9th EditionExplanation:"Patients with diffuse bilateral disease, of which cystic fibrosis is the best example, rarely benefit from resection and should be considered for lung transplantation as they approach end-stage disease. " (Ref: Schwartz)Treatment of BronchiectasisThe majority of patients with bronchiectasis do not require operative treatment.Postural drainage and chest physical therapy minimize retention of purulent sputum, and antibiotic treatment of all episodes of pneumonitis should be pursued indefinitely.When debilitating effects of chronic infection become prominent and surgery is contemplated, the anatomy should be defined carefully with CT scan before resection is planned.When extensive saccular disease is confined to one lobe or segment in a sufficiently symptomatic patient, resection is a clear choice.In children, interference with growth is often the sign of debility.Frequent hemoptysis associated with localized disease deserves operation.Patients with diffuse bilateral disease, of which cystic fibrosis is the best example, rarely benefit from resection and should be considered for lung transplantation as they approach end-stage disease.The operative strategy is to remove as little normal lung as possible without entering the central focus of infection.This usually requires segmentectomy or lobectomy and depends on an accurate preoperative assessment of the diseased segments.Pneumonectomy is rarely indicated in this disease.
Refractory foul smelling copious sputum
Hemoptysis
Bilateral disease
Bleeding
Stomach & Duodenum