Surgical Treatment of Bronchiectasis

Bronchiectasis is pathologically defined as a condition in which there are abnormal and permanent dilatations of proximal bronchi with predominance at the level of the second to the sixth bronchial division. This definition differentiates true bronchiectasis from functional bronchiectasis or pseudobronchiectasis, which is expected to return to normal once control of infection has been achieved (Deslauriers et al., 1998). Bronchiectasis was first described by Laenec in 1819 and, before the antibiotic era, was considered a morbid disease with a high mortality rate from respiratory failure and cor pulmonale (Balkanli et al., 2003). With the development of antibiotics in the 1940s, this entity began to be seen less frequently, but, with the emergence of drug-resistant microorganisms and the increasing frequency of drugresistant tuberculosis, an increased incidence of postinfectious bronchiectasis is being noted (Miller, 2000). The current increase in tuberculosis rates is directly related to insufficient and irregular medication. Additionally, irregular and inadequate treatment, the cessation of medication shortly after symptom improvement, and a lack of check-ups after treatment are factors accelerating recurrent pulmonary infection in developing countries. As the disease progresses, physical activities become increasingly limited, patients fail to thrive, and ultimately they suffer from social deprivation, intrinsic depression, and respiratory failure (Al-Kattan et al., 2005). Therefore, bronchiectasis is still a major cause of morbidity and mortality in developing countries.