The Surgical Management of Childhood Bronchiectasis

In 195 children with nontuberculous bronchiectasis, periodic bronchography and clinical examinations were conducted over a period of 16 years (average 9.4 years). This was provided a critical assessment of surgical accomplishments in 96 consecutive resections and a parallel observation of 111 cases not submitted to resection. The final clinical assessment of the surgical cases shows 75% to be well or much improved, 22% to be improved, and 4% unchanged, while patients not submitted to resection have remained largely unchanged (69%) or have become worse (23%). The isolated superior segment can be preserved in children with good results, provided there is clear bronchographic evidence that the segment is entirely free of disease. When partially diseased segments are retained and required to fill a large volume, there is a tendency for even slightly altered bronchi to deteriorate postoperatively. Serial bronchography has proved helpful in determining when the disease has reached a mature, stable state and in planning the extent of resection.