ABSTRACT
To assess the outcome of pulmonary resection in the management of massive hemoptysis caused by benign lung diseases. A longitudinal cohort study of 53 consecutive patients who presented with hemophsis and were treated with either emergency [group 1] or elective [group2] pulmonary resection from January 2001 to December 2003. Fifty-three patients were studied, 27 in group 1 and 26 in group 2. The mean age of the patients was 47.2 years [range, 29-70 years]. Urgent examination with a combination of rigid and flexible fiberoptic bronchoscope localized the bleeding site in 45 patients [85%] age >50 years, hypertension, hemoglobin on admission<10 g/dl, cause of hemoptysis, and a prior attack of hemoptysis were the predictors for the need of emergency surgery. The overall hospital mortality rate was 4% [2/53]. Postoperative complications occurred in 13 patients [25%]. Complications were more common in patients who received blood transfusion than non-transfused patients [9/23 and 4/30, respectively; P=0.03]. Patients with tuberculosis as the cause of massive hemoptysis had more complications 5/8 in comparison to all other patients [P=0.02]. The mean follow-up was 18 months [range, 12-24 months] for all patients who survived. Hemoptysis recurred in four patients [8%] and all from group I [P=0.02]. Immediate pulmonary resection for massive hemoptysis is effective in case of life-threarening bleeding that is not controlled by conservative measures. Elderly patients with a prior history of hemoptysis and/or hypertension and bleeding due to a fungus ball, necrotizing pneumonia, tuberculosis or lung abscess should be considered for early operation in an attempt to reduce morbidity and mortality