Opinion
Video
The Effects of the Heterogeneity of Bronchiectasis
Panelists discuss how surgical approaches for bronchiectasis have evolved from open thoracotomy to minimally invasive techniques (VATS or robotic assisted), reducing hospital stays from 5 to 7 days to 1 to 3 days and recovery time from 6 to 8 weeks to 2 to 6 weeks.
Clinical Brief: Surgical Approaches to Bronchiectasis
Main Discussion Topics
- Evolution from open thoracotomy to minimally invasive surgical techniques
- Preoperative optimization significantly affects surgical outcomes.
- Recovery times vary based on surgical approach.
Key Points for Physicians
- Surgical approaches:
- Traditional: open thoracotomy with 5- to 7-day hospitalization and 6- to 8-week recovery
- Modern: minimally invasive (VATS/RATS) with 1- to 3-day hospitalization and 2- to 6-week recovery
- Approximately 80% to 90% of cases can now be performed minimally invasively
- Preoperative optimization is essential:
- Control active infection/inflammation before surgery
- Stabilize symptoms
- Consider prophylactic bronchial artery embolization for hemoptysis cases
- Avoid emergency surgery when possible (20%-30% higher mortality)
Notable Insights
Controlled, elective surgery after appropriate medical optimization provides significantly better outcomes than emergency procedures, particularly for hemoptysis cases.
Clinical Significance
Minimally invasive surgical approaches have expanded treatment options for bronchiectasis but require careful patient selection and preoperative optimization for optimal outcomes.
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