Abstract
Objective: Hemoptysis is the expectoration of blood from the lower respiratory tract. Since the definitive treatment of hemoptysis often involves surgical intervention targeting the underlying disease, the initial assessment and preparation for surgical treatment are of critical importance.
Method: In our study, we retrospectively evaluated the data of patients who presented to the emergency department with hemoptysis and were operated on after being consulted by the department of thoracic surgery between 2012 and 2018. Patients were divided into groups: Those who underwent emergency surgery within the first 24 hours after hospitalization, those who underwent sub-elective surgery between the 1st and 3rd days, and those who underwent elective surgery on the 4th day and later.
Results: Of the 82 patients in our study, 60 (73.2%) were male and 22 (26.8%) were female. Hemoptysis was most frequently observed attributable to bronchiectasis (39%). During the preparation process for surgery, bronchial artery embolization (BAE) was performed on 16 patients (19.5%). The amount of hemoptysis in patients who underwent BAE was found to be statistically significantly higher (p=0.016). A total of 21 patients (25.6%) developed complications, none of whom had undergone pneumonectomy. Complications were found to be related to the amount of hemoptysis and length of hospital stay, but not to the application of BAE (p=0.017, p<0.001, and p=1.000, respectively). The proportion of patients who developed complications was lower in the elective group (28.6%) compared to other groups, but this difference was not statistically significant (p=0.594). Surgical mortality was observed in two patients (2.4%).
Conclusion: Although medical treatment and BAE play a significant role, in controlling the clinical condition preoperatively, the definitive treatment for hemoptysis is surgery targeting the underlying disease. In suitable patients, emergency surgery and complete resections such as pneumonectomy can be performed with acceptable rates of complications and mortality.
