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Eur J Cardiothorac Surg 2003;23:648
© 2003 Elsevier Science NL

Letter to the Editor

Reply to Metin et al.

Department of Thoracic Surgery, Haut-Lévêque Hospital, Bordeaux University Hospital, avenue de Magellan, 33604 Pessac, France

Received 16 December 2002; accepted 20 December 2002.

^* Corresponding author. Service de Chirurgie Thoracique du Pr JF Velly, CHU de Bordeaux, Hopital du Haut-Leveque, 33604 Pessac, France. Tel.: 56-55-50-09; fax: 56-55-50-21
e-mail: jacques.jougon{at}chu-bordeaux.fr

Key Words: Hemoptysis • Respiratory distress • Bronchial carcinoma • Tuberculosis • Bronchectasis • Bronchial arteries

We thank Dr Metin and associates for their interest in our paper and for sharing their experience of massive hemoptysis. They recommended a prompt surgical treatment whatever the patient and whatever the origin of bleeding. We want to congratulate them for their good result (11.5% mortality rate).

However, Dr Metin et al. did not specify the cause of bleeding and one may easily suppose that it is a typical surgical recruitment.

We do not believe that prompt surgery is always possible in poor functional status of the patient.

We think that it is not advisable to perform prompt pulmonary resection for massive hemoptysis occurring in cystic fibrosis patients, as in last course of radiotherapy for unresectable lung cancer, or in case of bilateral bronchiectasis?

These cases above mentioned are types of patient usually referred to us. As we wrote management is performed by a multidisciplinary approach. We have highlighted [1] the circumstances in which prompt surgical treatment may be required (bleeding coming from great pulmonary vessels).

One may suppose that at least three patients in Dr Metin's series might be treated by percutaneous embolization (those treated by segmentectomy). In other words, it seems difficult to treat all patients by prompt surgery in massive hemoptysis.

References

1. Jougon J., Ballester M., Delcambre F., Mac Bride T., Valat P., Gomez F., Laurent F., Velly J.F. Massive hemoptysis: what place for medical and surgical treatment?. Eur J Cardiothorac Surg 2002;22:345-351.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jacques Jougon Jean-Francois Velly Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jougon, J. Articles by Velly, J.-F. Search for Related Content PubMed Articles by Jougon, J. Articles by Velly, J.-F. Related Collections Anesthesia Lung - other