An update on bronchopleural fistulae following cancer-related surgery

Abstract

Purpose of ReviewBronchopleural fistulae (BPF) are rare complications in cancer-related surgery but impart significant morbidity and mortality. BPF may be difficult to identify, with a broad differential diagnosis at presentation, so it is critical to be aware of newer diagnostic and therapeutic approaches for this disease entity.Recent FindingsMultiple novel diagnostic and therapeutic interventions are featured in this review. Reports of newer bronchoscopic techniques to localize BPF, as well as approaches for bronchoscopic management, like stent deployment, endobronchial valve placement, or alternative interventions when indicated are discussed, paying particular attention to factors that influence procedure selection.SummaryManagement of BPF remains highly variable, but several novel approaches have shown improved identification and outcomes. Although a multidisciplinary approach is imperative, an understanding of these newer techniques is important to provide optimal care for patients.

Airway Stents in Interventional Pulmonology

“…This includes various ablative interventions to address the endoluminal component, followed by dilation and stent placement, if needed, to restore airway patency [6]. (A) (B) (A) (B) In addition to malignant airway obstructions and CAO, other airway disorders such as tracheoesophageal fistulae, bronchopleural fistulae, anastomotic dehiscence after lung transplantation or resection, and tracheobronchomalacia have all been managed with airway stenting at various times [13][14][15]. Post-tracheotomy or post-intubation airway stenosis, as well as post-infectious airway stenosis (particularly due to tuberculosis) have also been reported to be indications for airway stenting in specific clinical scenarios [7,[16][17][18][19][20][21].…”

Bronchopleural fistula after lobectomy: who is at risk in the modern era?

“…The study aimed to identify factors that could help predict the risk of BPF in patients undergoing lobectomy without any preoperative treatment, an important but understudied patient group. While the incidence of BPF has decreased due to advancements in surgical techniques and instruments, it remains a concern for the thoracic surgeon that warrants attention due to the high associated morbidity ( 2 ). The literature has previously documented right sided resection as a risk factor BPF after lung surgery ( 3 , 4 ).…”