Analysis of risk factors in the development of bronchopleural fistula after major anatomic lung resection: experience of a single centre

Nachira, Dania; Chiappetta, Marco; Fuso, Leonello; Varone, Francesco; Leli, Ilaria; Congedo, Maria Teresa; Margaritora, Stefano; Granone, Pierluigi

doi:10.1111/ans.13886

Cited by 7 publications

(12 citation statements)

References 21 publications

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“…The second group includes long bronchial stump distance, unsuitable suture material, sutures are too tight and stretched, extreme skeletonization of the bronchus, bronchial artery grafting or cauterization, inadequate closure of the bronchial instillation, and bleeding to the thoracic cavity. 16,17 In our study, possible risk factors were assessed with bronchial closure methods and no statistical difference was found between the two groups. However, we found that 88% of the cases were male, 96% were over 40 years, 69% of the patients had a BMI below 20, 65% of patients had a comorbidity, and in 73% of them the total protein/albumin values were abnormal, preoperatively endobronchial cauterisation (n=2) as a possible risk factor.…”

Section: Discussionmentioning

confidence: 74%

Evaluation of the Possible Risk Factors on Bronchial Closure Techniques for Bronchopleural Fistula after Lung Resection

Yanık¹,

Karamustafaoğlu²,

Yörük³

2020

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Background: Broncho-pleural fistula (BPF) can occur after pulmonary resections as a complication with high morbidity and mortality rates.    Aim: In the present study, we analyzed the relation between the possible risk factors and the two major bronchial closure techniques for BPF after lung resections, and the management methods of BPF.    Materials and methods: A total of 26 cases detected and managed with BPF diagnosis in our clinic between September 2005 and September 2017 were evaluated retrospectively. The cases were divided into two groups: Group 1 (n=14); bronchial closure performed manually and Group 2 (n=12) bronchial closure with stapler. We analyzed cases for age, gender, body mass index, pulmonary function tests, time to fistula, total protein/albumin level, length of hospital stay, bronchial stump distance, presence of bronchial stump coverage, and the mean survivals.   Results: Twenty-three of the cases were males (88.5%) with a mean age of 60.03±8.7 years (range 38-73). While BPF was detected in twenty-three (88.5%) of the cases after pneumonectomy, three (11.5%) of them were after lobectomy. There was no statistically significant correlation between the two groups in gender, age, BMI, preoperative FEV1, time to fistula, total protein/albumin level, length of hospital stay, bronchial stump distance, and presence of bronchial stump coverage (chi-square test, p>0.05). As a result of the applied Kaplan-Meier analysis, we found no statistically significant difference in the mean survival rates between the two groups (p>0.05).   Conclusions: Broncho-pleural fistulas still remains a major challenge. Although there is no statistical relationship between bronchial closure techniques and possible risk factors in our study, patients should be assessed in terms of possible risk factors. The management strategy for BPF varies according to individual patients’ clinical condition, the size of the fistula, and development time.

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Section: Discussionmentioning

confidence: 74%

Evaluation of the Possible Risk Factors on Bronchial Closure Techniques for Bronchopleural Fistula after Lung Resection

Yanık¹,

Karamustafaoğlu²,

Yörük³

2020

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“…Interestingly, the 17 patients predominantly had squamous cell carcinoma, a smoking history, large tumor size, and were undergoing lower lobectomy, all of which correspond to the predisposing factor for bronchopleural fistula after lung lobectomy. 1,[7][8][9][10] During the study period, we fortunately did not experience any cases of bronchopleural fistula after lung lobectomy. In addition, there were no apparent abnormalities in the bronchial stump during intraoperative thoracoscopic observation or during bronchoscope observation in two patients undergoing operation for empyema.…”

Section: Discussionmentioning

confidence: 99%

Unclassifiable Infectious Complications after Lobectomy for Cancer: Etiology, Risks, and Outcomes

Ueda

Murakami

Tanaka

et al. 2018

Thorac cardiovasc Surg

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“…По данным разных авторов частота развития бронхоплеврального свища после лобэктомии составляет от 0,3 до 3,8%, после пневмонэктомии от 4,5 до 40%. Летальность при развитии бронхоплеврального свища после пневмонэктомии пугающе высока от 18 до 71%, однако в случае развития бронхоплеврального свища после лобэктомии ситуация не так катастрофична [1,2,3,4,[5][6][7].…”

Section: №3 (45) 2022unclassified

The Use of Fibrin Glue in the Treatment of Bronchial Stump Failure After Lower Lobectomy on the Right (A Clinical Case)

Галлямов

Nikulin

Diduev

et al. 2022

jour

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Despite the constantly improving technique of operations, the use of modern suture materials and stitching-cutting devices, the problem of the occurrence of the failure of the bronchial stump remains unresolved. Many methods have been proposed for the treatment of bronchial stump failure, ranging from endoscopic mucosal coagulation and the installation of various types of occluders and ending with repeated surgical interventions. There are a huge number of publications devoted to the use of fibrin glue in various fields of medicine, for example, in neurosurgery, maxillofacial surgery, orthopedics, dentistry and thoracic surgery, fibrin glue is successfully used, including in the development of bronchial stump failure. This article presents a clinical observation of the use of fibrin glue in the treatment of bronchial stump failure after lower lobectomy on the right.

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Analysis of risk factors in the development of bronchopleural fistula after major anatomic lung resection: experience of a single centre

Abstract: Postoperative pulmonary infections, empyema and mechanical ventilation >24 h are strongly associated with the development of BPFs after both pneumonectomy and lobectomy in our series.

Cited by 7 publications

References 21 publications

Evaluation of the Possible Risk Factors on Bronchial Closure Techniques for Bronchopleural Fistula after Lung Resection

Evaluation of the Possible Risk Factors on Bronchial Closure Techniques for Bronchopleural Fistula after Lung Resection

Unclassifiable Infectious Complications after Lobectomy for Cancer: Etiology, Risks, and Outcomes

The Use of Fibrin Glue in the Treatment of Bronchial Stump Failure After Lower Lobectomy on the Right (A Clinical Case)

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