Endoscopic treatment of postoperative bronchopleural fistula: experience with 45 cases

Hollaus, Peter H.; Lax, Franz; Janakiev, Dan; Lucciarini, Paolo; Katz, E; Kreuzer, A.; Pridun, N

doi:10.1016/s0003-4975(98)00589-x

Cited by 103 publications

(77 citation statements)

References 12 publications

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“…Most have been reported as small case series or case reports. Among the sealants reported are fibrin or fibrin glue (51)(52)(53), cyanoacrylate glue (54,55), oxidized cellulose (56), albuminglutaraldehyde glue [2004], and hydrogel (57). Our review found no comparative studies, but reported complications are infrequent.…”

Section: Bronchoscopic Sealants Sclerosants and Implants For Palmentioning

confidence: 99%

Persistent air leaks: a review with an emphasis on bronchoscopic management

Lazarus

Casal

2017

J. Thorac. Dis.

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Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering from a pneumothorax. Its management can be complex and challenging. Although conservative treatment with chest drain and observation is usually effective, other invasive techniques are needed when conservative treatment fails. Surgical management and medical pleurodesis have long been the usual treatments for PAL. More recently numerous bronchoscopic procedures have been introduced to treat PAL in those patients who are poor candidates for surgery or who decline surgery. These techniques include bronchoscopic use of sealants, sclerosants, and various types of implanted devices. Recently, removable one-way valves have been developed that are able to be placed bronchoscopically in the affected airways, ameliorating air-leaks in patients who are not candidates for surgery. Future comparative trials are needed to refine our understanding of the indications, effectiveness, and complications of bronchoscopic techniques for treating PAL. The following article will review the basic principles of management of PAL particularly focusing on bronchoscopic techniques.

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Section: Bronchoscopic Sealants Sclerosants and Implants For Palmentioning

confidence: 99%

Persistent air leaks: a review with an emphasis on bronchoscopic management

Lazarus

Casal

2017

J. Thorac. Dis.

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“…Another landmark study describing a novel technique for closing central BPF dates back in 1998 [13]. Hollaus et al employed either only fibrin sealant, for the BPF 3 mm or less, or together with spongy calf bone, which was stuck in the fistula minimizing the orifice and preventing dislocation of the fibrin glue into the pleural cavity .…”

Section: Bronchoscopic Treatment Of Bronchopleural Fistulamentioning

confidence: 99%

Bronchoscopic management of bronchopleural fistula

Stamenovic¹

2016

Curr Thorac Surg

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Bronchopleural fistula (BPF) represents a pathological communication between any part of bronchial tree and the pleural space. Mostly it is a rare yet serious complication of different pulmonary conditions like certain infections, trauma, malignancy and/or surgery, going along with significant mortality reported to be as high as 58%. Diagnosis of BPF is mostly done by evaluating these three data: clinical appearance, bronchoscopy and CT scan. The treatment of BPF may initially differ according to the time of appearance as well as clinical presentation. As most BPF goes along with empyema, it is, obviously, necessary to deal with it. This is most commonly achieved with a chest tube. Conservative management of BPF can be achieved using a significant variety of materials and methods with reportedly moderate to excellent results in the treatment of etiologically and sizably different BPF. Methyl-2-cyanoacrylate, fibrin sealant together with spongy calf bone, polidocanol -hydroxypolyethoxidodecane, amplatzer device, silver nitrate, stenting and endobronchial valves have all been employed in bronchoscopic treatment of a BPF. There is no evidence based guideline for its management, either surgically or endoscopically. The treatment of choice is always in the hands of the physician, preferably armed with the current knowledge and capacity of utilizing it.

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“…Furthermore, it should be performed in all patients with persistent air leak to exclude stump dehiscence, as its presence will often necessitate surgery to treat the problem. Should surgery be contraindicated for whatever reason, a large number of endobronchial approaches have been studied as an alternative therapeutic option for bronchopleural fistulas, including the use of glue (85,86) In addition, the placement of endobronchial valves is a new technique that has emerged recently for the treatment of persistent air leak in patients with underlying lung disease such as emphysema that are not candidates for more extensive procedures such as surgery (96,97). Endobronchial one-wave valves inserted via bronchoscopy were initially developed as an investigational technique to treat emphysema by promoting atelectasis of emphysematous lungs distal to the valve, which would allow air to exit via the valve but not re-enter.…”

Section: Bronchoscopy and Endobronchial Techniquesmentioning

confidence: 99%