Endobronchial closure of a postpneumonectomy bronchopleural fistula

Opie, John C.; Vaughn, Cecil C.; Radford, Joseph M.; Lowell, Patricia; Finch, C. T.

doi:10.1016/0003-4975(92)90335-2

Cited by 17 publications

(5 citation statements)

References 7 publications

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“…Additionally, surgeons need to determine whether to perform a one-stage closure or fenestration to treat the BPF. Small fistulas can be treated via transbronchial approach [ 2 , 3 ], whereas large fistulas or fistulas in cases with concurrent pyothorax require fenestration. One-stage closure may be applicable in cases with favorable infection control.…”

Section: Discussionmentioning

confidence: 99%

Pedicled gastric seromuscular patch for one-stage closure of a bronchopleural fistula: a case report

et al. 2018

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BackgroundOne-stage closure and fenestration are the available surgical options for bronchopleural fistula (BPF). One-stage closure may be applicable in cases with favorable infection control. Closing the bronchopleural stump is difficult due to thick adhesion caused by inflammation and a high risk of pulmonary artery injury. We report the successful closure of a BPF using a gastric seromuscular patch with an omental pedicle flap.Case presentationA 73-year-old man underwent right lower lobectomy with ND2a-2 lymph node dissection for lung adenocarcinoma. He was admitted to a local hospital for pneumonia. Three days after admission, his thoracic cavity was drained and a BPF was suspected. During the primary operation, the latissimus dorsi muscle and anterior serratus muscle were dissected via posterolateral incision, and we decided to close the fistula using the gastric seromuscular layer and omental pedicle flap. The patient was discharged 20 days after surgery. After 2 years, he has not had cancer recurrence and currently leads an active life.ConclusionsThis method provided immediate airtight closure and luminal opening of the middle bronchus in our patient with a large BPF and appeared superior to using the omentum alone. This procedure is useful for one-stage closure and does not require fenestration in cases with favorable infection control.

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Section: Discussionmentioning

confidence: 99%

Pedicled gastric seromuscular patch for one-stage closure of a bronchopleural fistula: a case report

et al. 2018

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“…A BPF after segmental or pulmonary lobar resection can be treated using tube drainage alone, and small fistulas may be treated by transbronchial injection or with fibrin adhesives. [2][3][4][5] Surgery is required for large fistulas or cases with pyothorax, and open treatment and purging of pyothorax after plombage is performed in cases with poor infection control. 6) Open emergency treatment is safe, but places a heavy burden on the patient and medical staff.…”

Section: Introductionmentioning

confidence: 99%

Two Cases of Single-Stage Closure of a Bronchopleural Fistula Using Latissimus Dorsi Musculocutaneous Flaps after Lung Surgery

Nakajima

Akiyama

Kinoshita

et al. 2015

ATCS

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“…Once, surgical resection is considered a curative treatment, but is associated with a high mortality rate, reaching approximately 67% (1,2). Through a literature review, we found four similar case reports including 4 patients (3)(4)(5)(6). All reported cases were treated with antibiotics, and 3 patients underwent open window thoracotomy, and 1 patient closed BPF with bronchoscopic biological glue occlusion successfully who was discharged from the hospital more quickly in all patients (6).…”

Section: Introductionmentioning

confidence: 91%

A novel therapeutic strategy to close bronchopleural fistula related to Mycobacterium chelonae in elderly patients: two case reports and literature review

Liu¹,

Huang²,

Luo³

et al. 2022

Ann Transl Med

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Background: Mycobacterium chelonae (M. chelonae) empyema complicated with bronchopleural fistula (BPF) remains a significant challenge in diagnosis and treatment and the clinical outcomes are often unsatisfactory, especially in elderly patients. There is a paucity data related to the management of the condition. This is the first well-documented report of the therapeutic experience with bronchoscopic closure of a bronchopleural fistula with empyema related to M. chelonae infection in the elderly patients.Case Description: An 86-year-old non-smoking male with a history of diabetes mellitus, emphysema, and bronchiectasis, and a 72-year-old non-smoking male with two past surgeries for lung cancer, both presented with chronic fever, purulent expectoration, hemoptysis, and dyspnea, and were diagnosed with bronchopleural fistula associated with M. chelonae infection. Long-term antibiotic regimens, prolonged thoracic drainage, and endoscopic closure with biological glue were all unsuccessful. The culprit bronchus was identified precisely with the combined assistance of the instillation of methylene blue and the Chartis digital air leak monitoring system. Bronchoscopic interventional therapy was successfully performed using the Zephyr one-way endobronchial valve or the Amplatzer patent ductus arteriosus occluder. Finally, two patients succeeded in removing chest tube, and were able to conduct daily activities. Conclusions:The successful bronchoscopic closure with the combined assistance of methylene blue and the Chartis digital air leak monitoring system provided valuable experience and novel strategy in dealing with BPF related to M. chelonae in the elderly and high-risk inoperable patients.

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Endobronchial closure of a postpneumonectomy bronchopleural fistula

Cited by 17 publications

References 7 publications

Pedicled gastric seromuscular patch for one-stage closure of a bronchopleural fistula: a case report

Pedicled gastric seromuscular patch for one-stage closure of a bronchopleural fistula: a case report

Two Cases of Single-Stage Closure of a Bronchopleural Fistula Using Latissimus Dorsi Musculocutaneous Flaps after Lung Surgery

A novel therapeutic strategy to close bronchopleural fistula related to Mycobacterium chelonae in elderly patients: two case reports and literature review

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