Thorac Cardiovasc Surg 2021; 69(06): 577-579
DOI: 10.1055/s-0040-1721676
Short Communication

Postoperative Bronchopleural Fistula: A Conservative Way of Treatment in Selected Cases

Dario Amore
1   Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy
,
Umberto Caterino
2   Thoracic Endoscopic Unit, Monaldi Hospital, Naples, Italy
,
Dino Casazza
1   Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy
,
Pasquale Imitazione
3   Department of Respiratory Diseases, Monaldi Hospital, Naples, Italy
,
Carlo Bergaminelli
1   Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy
,
Simona Massa
4   Complex Operative Unit of Pathology, Monaldi Hospital, Naples, Italy
,
Carlo Curcio
1   Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy
› Institutsangaben

Abstract

Background Postoperative bronchopleural fistula represents a challenging issue for thoracic surgeons. The treatment options reported include bronchoscopic or surgical procedures but the method yielding the best results remains unclear.

Methods In our thoracic surgery department, between January 2011 and June 2020, 11 patients treated conservatively for early bronchopleural fistula after lobectomy or bilobectomy were reviewed. The fistula size ranged between 2 and 3 mm and complete suture dehiscence.

Results In all 11 patients favorable conditions such as clinical stability, complete expansion of the remaining lung, and resolution of the pleural infection allowed a successful conservative treatment with chest tube drainage.

Conclusion In selected cases, conservative management of early bronchopleural fistula after lobectomy or bilobectomy may be an alternative therapeutic option to bronchoscopic or surgical procedures, regardless of the fistula size.



Publikationsverlauf

Eingereicht: 06. Juli 2020

Angenommen: 16. Oktober 2020

Artikel online veröffentlicht:
18. Januar 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Cerfolio RJ. Early postoperative complications. In: Patterson GA, Cooper JD, Deslauriers J. et al. eds. Pearson's Thoracic & Esophageal Surgery. 3rd ed.. Philadelphia, PA: Churchill Livingstone, Elsevier; 2008: 160-165
  • 2 Cardillo G, Carbone L, Carleo F. et al. The rationale for treatment of post resectional bronchopleural fistula: analysis of 52 patients. Ann Thorac Surg 2015; 100 (01) 251-257
  • 3 Lois M, Noppen M. Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management. Chest 2005; 128 (06) 3955-3965
  • 4 Mao R, Ying PQ, Xie D. et al. Conservative management of empyema-complicated post-lobectomy bronchopleural fistulas: experience of consecutive 13 cases in 9 years. J Thorac Dis 2016; 8 (07) 1577-1586
  • 5 Boudaya MS, Smadhi H, Zribi H. et al. Conservative management of postoperative bronchopleural fistulas. J Thorac Cardiovasc Surg 2013; 146 (03) 575-579
  • 6 Shigeki S, Tomohiro I, Kenichi H. Endoscopic treatment of bronchopleural fistula using ethyl-2-cyanoacrylate: a report of two cases. Respir Med Case Rep 2020; 30: 101123
  • 7 Fruchter O, El Raouf BA, Abdel-Rahman N, Saute M, Bruckheimer E, Kramer MR. Efficacy of bronchoscopic closure of a bronchopleural fistula with amplatzer devices: long-term follow-up. Respiration 2014; 87 (03) 227-233
  • 8 Massera F, Robustellini M, Della Pona C, Rossi G, Rizzi A, Rocco G. Open window thoracostomy for pleural empyema complicating partial lung resection. Ann Thorac Surg 2009; 87 (03) 869-873
  • 9 Uramoto H, Hanagiri T. The development of bronchopleural fistula in lung cancer patients after major surgery: 31 years of experience with 19 cases. Anticancer Res 2011; 31 (02) 619-624