Is there still a place for pneumonectomy in bronchiectasis ?

<bold>Introduction:</bold> Bronchiectasis is defined as a permanent and irreversible enlargement of the bronchial tubes. Treatment is essentially medical, but may be surgical in localized forms. Pneumonectomy is extremely rare and is reserved for bronchiectasis destroying the entire lung or complications such as recurrent infections or hemoptysis. <bold>Methods:</bold> Retrospective study about 14 patients who underwent pneumonectomy for bronchiectasis, from 2012 to 2022. <bold>Results:</bold> They were 6 men and 8 women, with an average age of 40. Four patients had a history of treated and cured pulmonary tuberculosis, and one patient had undergone surgery for a hydatid cyst of the same lung. Symptomatology was dominated by hemoptysis in 8 cases and recurrent infections in the other 8 cases. Parenchymal destruction was found in 7 cases and chronic pulmonary abscess in only 1 case with failure of medical treatment. One patient underwent emergency surgery for severe hemoptysis. All patients had a CT scan. Pneumonectomy through a posterolateral thoracotomy was performed in all cases. Complications included bronchopleural fistula with empyema (1 patient), secondary pneumothorax (1 patient) and postoperative pneumopathy (2 patients). Anatomopathological examination showed isolated bronchiectasis lesions (9 cases), bronchiectasis associated with aspergilloma (4 cases) and broncholithiasis (1 case). Post operative course was uneventfull, with significant improvement in symptomatology. <bold>Conclusion:</bold> Bronchiectasis is a disabling pathology that remains frequent in developing countries, particularly in Tunisia. Surgery is generally performed for localized forms. Pneumonectomy may be indicated in well-selected cases with good results.