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Management of massive haemoptysis
Abstract
Background: This study compares two management techniques in the treatment of massive haemotysis.
Method: All patients with massive haemoptysis treated between January 1969 and December 1980 (group 1) were retrospectively reviewed and those prospectively treated between January 1981 and August 1999 (group II) were analysed. Group I patients had emergency bronchoscopy and surgery while group II patients had interval conservative care before bronchoscopy and definitive surgical management.
Results: Both groups have comparative age and sex distribution and infective pulmonary diseases dominated as causes of massive haemoptysis. Recurrent haemoptysis occurred in 15 patients (22.7%) of group II during preoperative waiting period. In group I, bronchoscopy was abandoned in 5 patients and was immediately fatal in 1 patient. No such experiences in group II. The number of pneumonectomies were 12 out of 18 procedures (66.7%) for group I and 19 out of 68 procedures (27.9%) in group II. There were 5 lobectomies (27.8%) in group I and 49 (72.5%) in group II. Operative mortality was 72.2% for group I and 7.4% for group II.
Conclusion: Initial unduly prolonged, conservative therapy followed by appropriately timed operative intervention produced the best outcome.
Keywords: Massive haemoptysis, treatment.
Nig. J. of Surgical Research Vol.4(3-4) 2002:67-74
Method: All patients with massive haemoptysis treated between January 1969 and December 1980 (group 1) were retrospectively reviewed and those prospectively treated between January 1981 and August 1999 (group II) were analysed. Group I patients had emergency bronchoscopy and surgery while group II patients had interval conservative care before bronchoscopy and definitive surgical management.
Results: Both groups have comparative age and sex distribution and infective pulmonary diseases dominated as causes of massive haemoptysis. Recurrent haemoptysis occurred in 15 patients (22.7%) of group II during preoperative waiting period. In group I, bronchoscopy was abandoned in 5 patients and was immediately fatal in 1 patient. No such experiences in group II. The number of pneumonectomies were 12 out of 18 procedures (66.7%) for group I and 19 out of 68 procedures (27.9%) in group II. There were 5 lobectomies (27.8%) in group I and 49 (72.5%) in group II. Operative mortality was 72.2% for group I and 7.4% for group II.
Conclusion: Initial unduly prolonged, conservative therapy followed by appropriately timed operative intervention produced the best outcome.
Keywords: Massive haemoptysis, treatment.
Nig. J. of Surgical Research Vol.4(3-4) 2002:67-74
