Surgical treatment of non-cystic fibrosis bronchiectasis in children and adolescents: A review.

ABSTRACT

OBJECTIVE: To discuss surgery for non-cystic fibrosis [CF] bronchiectasis in children and adolescents. SOURCES Non-systematic review including articles in English, mainly from the last 5 years. SUMMARY OF FINDINGS: In this review, we present that in low- and middle-income countries [LMIC] clinical treatment fails in around 20% of cases due to low socioeconomic status and poor adherence. This causes the disease to progress and require surgery. We emphasize that the indications for surgery are not well defined and must be considered on an individual basis. The surgical treatment of bronchiectasis in children may be indicated in selected cases; especially in localized disease with frequent exacerbations despite an optimized clinical approach. Surgery can improve quality of life [QoL] and reduce exacerbations. It has few postoperative complications and low morbidity and mortality. Finally, we propose an algorithm for managing bronchiectasis, which takes into account LMIC settings with limited resources. CONCLUSION: We conclude that in LMICs, surgery is a treatment strategy for selected children/adolescents with bronchiectasis.