Early Detection of Occult Bronchopleural Fistula After Routine Standard Pneumonectomy

Misthos, Panagiotis; Konstantinou, Marios; Kokotsakis, John; Skottis, Ion; Lioulias, Achilleas

doi:10.1055/s-2005-872975

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…2Y4 However, early bronchoscopy was not sensitive for the detection of bronchopleural communication. 18 Occult BPF or microfistula in which a tiny bronchial stump dehiscence may be present without objective confirmation with conventional modalities has been reported in the literature. 18,26 In this study, CT demonstrated central BPF in most cases including 1 patient with negative finding on bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…18 Occult BPF or microfistula in which a tiny bronchial stump dehiscence may be present without objective confirmation with conventional modalities has been reported in the literature. 18,26 In this study, CT demonstrated central BPF in most cases including 1 patient with negative finding on bronchoscopy. This result suggests that thin-section axial volume dataset and MPR images of multiYdetector row CT can enable the detection of small central BPF, which is difficult to detect by bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multi-Detector Row Computed Tomographic Evaluation of Bronchopleural Fistula

Seo¹,

Kim²,

Jin³

et al. 2010

Journal of Computer Assisted Tomography

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multi-Detector Row Computed Tomographic Evaluation of Bronchopleural Fistula

Seo¹,

Kim²,

Jin³

et al. 2010

Journal of Computer Assisted Tomography

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show abstract

“…While a gradual rise in air-fluid level within a few days (progressive mediastinal shift and lung herniation) and total obliteration of the postpneumonectomy space within weeks to months demonstrate the normal changes, unexpected deviations indicate the onset of possible complications. 16,35,36 CT should only be used in the presence of inconclusive radiographic findings, especially in the late postoperative period. The lateral decubitus position, which improves matching of pulmonary ventilation and perfusion, 37,38 and chest physiotherapy and postural training, which support the functional capacity and avoid thoracal deformities, 1 are other keen points in the prevention of postoperative morbidity.…”

Section: Discussionmentioning

confidence: 99%

Childhood Pneumonectomies: Two Decades' Experience of a Referral Center

et al. 2012

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Correct selection of indications, careful preoperative preparation with eradication of infection, meticulous performance of surgical and anesthetic techniques, early detection and management of complications, and long-term follow-up including pulmonary rehabilitation are essential parameters to reduce morbidity and mortality rates in childhood pneumonectomy. Better compensatory lung growth and improvement in development after the operation will facilitate better health and improved life quality in children.

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“…Despite the advances in the surgical techniques, BPF is still an important clinical problem with high morbidity and mortality particularly after right pneumonectomy [1]. Bronchoscopic and radiological evaluation are most popular for the localization/ confirmation of the fistula [3,4]. Bronchoscopic evaluation is critical for the early diagnosis of a small fistula when the symptoms of the fistula are not clear.…”

Section: Discussionmentioning

confidence: 99%

Argon plasma coagulation as an alternative treatment for bronchopleural fistulas developed after sleeve pneumonectomy

Aynacı¹,

Kocatürk²,

Yıldız³

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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We present a case that used argon plasma coagulation (APC) for the healing of bronchopleural fistulas (BPF), which most probably developed secondary to tracheobronchial anastomotic failure (TBAF). We aimed to show this procedure as an alternative treatment for the small fistulas that could develop after pneumonectomy. In a 56-year old male patient, right upper lobe squamous cell carcinoma was detected in 2009. Sleeve pneumonectomy was done because of the carina and major fissure invasion. There was no morbidity in the early post-operative period. The patient was discharged on the seventh day without any problems. Three cycles of chemotherapy were applied. In the third month after operation, the patient complained of a cough, and odorous sputum starting 15 days earlier. Two fistula orifices (1 and 3 mm) were detected in the fibre-optic bronchoscopy (FOB). No sign of tumour recurrences was detected in either chest computed tomography (CT) or FOB. BPF had entered the mediastinal chamber, which isolated the infection from the pleural cavity. The APC procedure was applied using FOB under local anaesthesia. The processing time was 30 min. There were no complications during or after the procedure. FOB was repeated 30 days later, and none of the previously opened orifices were observed. The patient was followed up for 18 months without any symptoms. APC was generally used for the treatment of oesophageal and intestinal fistula. We could not find any cases in the literature about APC application to treat BPF. APC could be an alternative treatment for the selected cases with small, uncomplicated BPF.

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Early Detection of Occult Bronchopleural Fistula After Routine Standard Pneumonectomy

Abstract: Chest radiology proved to be the diagnostic modality of choice for early detection of bronchopleural fistula.

Cited by 6 publications

References 12 publications

Multi-Detector Row Computed Tomographic Evaluation of Bronchopleural Fistula

Multi-Detector Row Computed Tomographic Evaluation of Bronchopleural Fistula

Childhood Pneumonectomies: Two Decades' Experience of a Referral Center

Argon plasma coagulation as an alternative treatment for bronchopleural fistulas developed after sleeve pneumonectomy

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