Bronchiectasis: Is there a role for video-assisted thoracic surgery?

Sir,

We have read with great interest the article by Cobanuglu et al. concerning the role of surgery in the treatment of bronchiectasis and the effect of morphological type to prognosis.[1] The authors are to be congratulated for their very good results in terms of morbidity and mortality following surgical treatment. The aim of our brief comment is to highlight the role of video-assisted thoracic surgery (VATS) in selected cases of bronchiectasis. It is established in the international literature that, in experienced hands, VATS is a safe alternative to open procedures in the management of bronchiectasis.[2] Young patients with (1) localized bronchiectasis, (2) no severe pulmonary or pleural scarring and (3) absence of calcified lymph nodes near pulmonary vessels are eligible for VATS. The severity of adhesions to the hilum and, especially, in the fissure is the key limiting factor for a safe VATS major resection. Minimally invasive techniques such as VATS are increasingly used and provide an alternative approach to the management of bronchiectasis. Certainly, increased and ongoing experience with VATS will allow us to perform more sophisticated procedures in the near future.