eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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4/2021
vol. 18
 
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abstract:
Original paper

Emergency pulmonary resection in massive hemoptysis: analysis of 39 patients

Serkan Yazgan
1
,
Ahmet Ucvet
1
,
Kenan Can Ceylan
1
,
Canberk Heskiloglu
1
,
Banu Yoldas
1
,
Serpil Sevinc
1

  1. Department of Thoracic Surgery, Health Sciences University, Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey
Kardiochirurgia i Torakochirurgia Polska 2021; 18 (4): 203-209
DOI: https://doi.org/10.5114/kitp.2021.112185
Online publish date: 2022/01/09
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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.

keywords:

hemoptysis, pneumonectomy, bronchiectasis, tuberculosis, pulmonary aspergillosis
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