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Background The feasibility of completing a Iobectomy by completely video-assisted thoracoscopic surgery (cVATS) in the management of bronchiectasis is unclear.By retrospectively comparing the outcomes from the Iobectomies that used thoracotomy vs.cVATS,we determined the appropriateness of the minimally invasive cVATS approach in the management of bronchiectasis.Methods Between June 2001 and October 2010,60 patients with bronchiectasis underwent surgery,of which 56 Iobectomies were performed.All Iobectomies were carried out by either thoracotomy or cVATS approach.Pulmonary vessels and bronchi were manipulated by ligation or stapler in the thoracotomy group,while they were dissected by endo-cutters in the cVATS group.Results There were 21 patients in the thoracotomy group and 35 patients in the cVATS group.Two cVATS patients (5.7％) converted.The difference in operation time,chest tube duration,lengths of hospitalization,and morbidity were not significantly different between the two groups (P ＞0.05).The blood loss was less in the cVATS group (P=0.015).A total of 52.4％ and 62.9％ of patients were postoperatively asymptomatic in the thoracotomy and cVATS groups respectively,and symptomatic improvement was obtained in 38.1％ patients by thoracotomy vs.31.4％ patients by cVATS.Conclusion cVATS Iobectomy is safe and effective for the management of bronchiectasis,especially for the patients with localized lesions.