A study of lung resection for haemoptysis with or without pre-operative bronchial artery embolisation

Abstract

Background:Massive and recurrent haemoptysis are associated with extreme mortality. Most authors concede that massive haemoptysis is defined as coughing out of blood 600 ml in 24 hours or 250 ml in a single bout. Recurrent haemoptysis is the one condition where the patient coughs out significant amount of blood more than once. Both these conditions are associated with 30% to 50% mortality. The objective of this review is to evaluate the outcome of lung resection for haemoptysis with or without pre-operative bronchial artery embolisation (B.A.E.). It may be advisable to bypass the B.A.E. and proceed directly to lung resection.

Methods: Retrospective review of case records from March, 2008 to March 20015, admitted to the department of Cardiothoracic Surgery with haemoptysis (3 cases of massive and 15 cases of recurrent haemoptysis) deemed suitable for lung resection was undertaken. When B.A.E was undertaken the lung resection was necessitated due to recurrent haemoptysis.

Results:18 Patients with significant haemoptysis (massive 3, recurrent 15) were evaluated 15 patients had lung resection without B.A.E and 3 patients following B.A.E had recurrent haemoptysis needing lung resection. None of the patients developed recurrence after surgery and one patient had empyema thoracis which was drained.

Conclusions:The lung resection is feasible in appropriately selected cases with radiologically localized disease and haemoptysis. This study suggests that B.A.E is probably best utilized as a temporary measure to control bleeding.