Konstantinos Potaris, Victor F. Trastek, Mark S. Allen, Claude Deschamps, Daniel L. Miller*, Peter C. Pairolero

Mayo Clinic

Rochester, Minnesota, USA

The purpose of this study was to update our results of surgery for patients who present with broncholithiasis and its complications.

Between January 1984 and January 1998, we retrospectively reviewed the medical records of 118 patients in whom broncholithiasis was diagnosed at our institution. Forty-seven underwent broncholithectomy via thoracotomy.

There were 19 men and 28 women; median age of 58 years (range 18 to 90 years). Indications for surgery included symptoms in 44 patients and abnormal x-rays in three. Surgical procedures included lung resection in 30 patients, segmental bronchial resection in one, and broncholithectomy with or without bronchoplasty in 16. Postoperative complications occurred in 17 patients (36%). There was no postoperative mortality. Follow-up was complete in 46 patients (98%), with a median of 74 months (range 11 to 165 months). Twenty-eight patients (72%) were asymptomatic. There was no statistically significant difference in the 15-year survival rate (Kaplan-Meier) when compared to a control group (P=0.801). Recurrent or persistent disease was observed in six patients. The site was in a new area in three patients, previous site of surgery in two, and unknown in one. Treatment included observation in three patients, bronchoscopic removal in two, and bilobectomy in one.

Surgical resection for broncholithiasis is an effective method for the eradication of this disease and can be done with low mortality and acceptable morbidity. Evolution of the disease process may lead to recurrence and further intervention.