Emergency pulmonary resection in massive hemoptysis: analysis of 39 patients


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YAZGAN S., ÜÇVET A., CEYLAN K. C., Heskiloglu C., Yoldas B., SEVİNÇ S.

Kardiochirurgia i Torakochirurgia Polska, cilt.18, sa.4, ss.203-209, 2021 (ESCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 4
  • Basım Tarihi: 2021
  • Doi Numarası: 10.5114/kitp.2021.112185
  • Dergi Adı: Kardiochirurgia i Torakochirurgia Polska
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, Directory of Open Access Journals
  • Sayfa Sayıları: ss.203-209
  • Anahtar Kelimeler: hemoptysis, pneumonectomy, bronchiectasis, tuberculosis, pulmonary aspergillosis
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Introduction: The mortality of massive hemoptysis is high, and it is important to make quick decisions. Emergency pulmonary resection continues to be a mandatory option when conservative methods cannot prevent massive hemoptysis, as it is life-threatening. Aim: We report our experience with patients undergoing pulmonary resection for massive hemoptysis. Material and methods: This study is a retrospective analysis of 39 consecutive patients who were referred to the thoracic surgery intensive care unit of a tertiary hospital for massive hemoptysis and underwent emergency pulmonary resection by thoracotomy between January 2007 and March 2021. Results: Male dominance with an average age of 49.3 (16–70) and a gender ratio of 3.3 were recorded. The most common underlying cause of massive hemoptysis was bronchiectasis (n = 16). Bronchiectasis was followed by aspergilloma (n = 11) and previous tuberculosis (n = 8). Bronchial artery embolization was performed in 20.5% of patients. Twenty-nine (74.4%) lobectomies, 7 (17.9%) pneumonectomies, and 3 (7.7%) segmentectomies were performed. The mean operation duration was 253.6 ±71 minutes. Recurrent hemoptysis was recorded in 7.7% of patients. Postoperative life-threatening complications were seen in 28.2%, while minor complications developed in 28.2% of patients. Postoperative complications were significantly higher in patients with tuberculosis sequelae (p = 0.006). Hospital mortality was observed in 5.1% of patients. Conclusions: The postoperative period is more problematic in patients with a history of tuberculosis who undergo emergency pulmonary resection due to massive hemoptysis. Despite this, emergency pulmonary resection is a curative method with acceptable postoperative complications and low hospital mortality in all tolerant patients according to their clinical condition.