Surgery for hemoptysis - one year experience of 72 patients

ABSTRACT

To determine aetiology of patients presenting with hemoptysis and evaluate their management and outcome. Study Design: An observational prospective descriptive study. Place and Duration Department of Cardiothoracic Surgery, Postgraduate Medical Institute, Lady Reading Hospital from 1st Jan 2003 to 31st December 2003. Materials and This prospective study included 72 patients; 51[71%] were males and 21[29%] were females. Male female ratio was 2.51 Age range was from 7 years to 81 years with a mean age of 36.3 years. All the patients had hemoptysis o n presentation while 25[35%] also experienced dyspnoea. Chest radiograph was obtained in all, CT Thorax in 60 [83%] while pulmonary function tests were performed in 68[94%] patients. Out of 72 cases 09 patients had to undergo immediate surgery, 27 underwent surgery within one week after initial stabilization and 36 were operated upon electively. All patients, except 6 pediatrics cases, had one lung ventilation during surgery. The mean operative time was 55[ +/- 20] minutes. Out of 72 patients 30 had lobectomy, 24 had hydatid cystectomy, 9 had wedge excision, 3 had pneumonectomy and 6 had thoracoplasty. Mortality was 2/72 while morbidity was 6/72 comprising 4 wound infections [in the emergency group] and 2 each had persistent air leak and empyema. Hospital stay ranged from 7 - 36 days with mean of 12.6 days. Pathological breakup of the 72 cases was bronchiectasis 30, mycetoma 2, lung abscess 9, hydatid cysts 24, carcinoma 6 and AV malformation 1. Inflammatory lung disease, especially TB and its sequelae is the commonest cause of hemoptysis. Elective surgery with one lung ventilation after initial stabilization in a well equipped and well staffed cardiothoracic unit [OT and ICU] is a safe option for hemoptysis, not responding to medical management