OBJECTIVES To provide the experience of surgical treatment for bronchiectasis-destroyed lung and evaluate the feasibility of video-assisted thoracoscopic surgery. METHODS Bronchiectasis-destroyed lung patients underwent surgical treatment between January 2013 and June 2018 were included. Logistic regression was performed to assess factors for major complications, and Cox's regression was performed to assess factors affected symptomatic outcome. RESULTS Totally 143 patients were treated by video-assisted thoracoscopic surgery (n = 64) and thoracotomy (n = 79). Nine (14.1%) cases scheduled for video-assisted thoracoscopic surgery were converted to thoracotomy for dense adhesions (n = 6) and frozen hilum (n = 3). The video-assisted thoracoscopic surgery group had a median chest tube duration, hospitalization, and a time of returning to full activity of 4 days, 5 days, and 1.5 months, respectively. Major complications occurred in 28 (19.6%) of all patients, 50.0% after pneumonectomy and 13.4% after lobectomy/extensive lobectomy. Multivariable analysis identified pneumonectomy (odds ratio [OR], 3.64; 95% confidence interval [CI], 1.18-11.21) as a significant predictor for major complications. Overall, 141 (98.6%) patients benefited from surgery (completely asymptomatic, n = 109; acceptable alleviation, n = 32). Thirty-four patients experienced relapse of the disease, including 13 with productive cough, 11 with haemoptysis, and 10 with recurrent infections. Pseudomonas aeruginosa infection (hazard ratio [HR], 3.07; 95% CI, 1.38-6.83) and extent of remanent bronchiectatic areas (HR, 1.03; 95% CI, 1.00-1.05) were independent risk factors for shorter relapse free interval. CONCLUSIONS Video-assisted thoracoscopic surgery for bronchiectasis-destroyed lung is feasible in well-selected patients. Pneumonectomy increased the risk of postoperative major complications. Removing all bronchiectasis-destroyed lung lesions contributed to satisfactory prognosis.

中文翻译：

---

支气管扩张破坏肺的手术：电视胸腔镜手术的可行性和手术结果。

目的 总结支气管扩张破坏肺的手术治疗经验，评价电视胸腔镜手术的可行性。方法纳入2013年1月至2018年6月期间接受手术治疗的支气管扩张破坏肺部患者。进行逻辑回归以评估主要并发症的因素，并进行Cox回归以评估影响症状结果的因素。结果 共有143例患者接受了电视胸腔镜手术（n = 64）和开胸手术（n = 79）。9 例（14.1%）原定进行电视胸腔镜手术的患者因粘连严重（n = 6）和肺门冻结（n = 3）而转为开胸手术。电视胸腔镜手术组的中位胸管持续时间、住院时间和完全恢复活动时间分别为 4 天、5 天和 1.5 个月。所有患者中有 28 名（19.6%）发生主要并发症，其中 50.0% 发生在全肺切除术后，13.4% 发生在肺叶切除/广泛肺叶切除术后。多变量分析确定全肺切除术（比值比 [OR]，3.64；95% 置信区间 [CI]，1.18-11.21）是主要并发症的重要预测因素。总体而言，141 名 (98.6%) 患者从手术中受益（完全无症状，n = 109；可接受的缓解，n = 32）。34例患者病情复发，其中咳痰13例，咯血11例，反复感染10例。铜绿假单胞菌感染（风险比[HR]，3.07；95% CI，1.38-6.83）和残留支气管扩张区域的范围（HR，1.03；95% CI，1.00-1.05）是无复发间隔缩短的独立危险因素。结论 对于经过精心挑选的患者，电视胸腔镜手术治疗支气管扩张破坏的肺部是可行的。全肺切除术增加了术后主要并发症的风险。去除所有支气管扩张破坏的肺部病变有助于获得满意的预后。