Modified Dumon stent for the treatment of a bronchopleural fistula after pneumonectomy

Tayama, Keiichiro; Eriguchi, Naofumi; Futamata, Yasuhiko; Harada, Hiroshi; Yoshida, Atsushi; Matsunaga, Akira; Mitsuoka, Masahiro

doi:10.1016/s0003-4975(02)04282-0

Cited by 43 publications

(31 citation statements)

References 6 publications

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“…Stump fistulas or dehiscences have been treated by offthe-shelf or modified stents. They have been used to bridge the gap between or complementing surgery [96,111,112]. In any THERAPEUTIC BRONCHOSCOPIC PROCEDURES C.T.…”

Section: Clinical Experience and Resultsmentioning

confidence: 99%

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Bolliger¹

2006

Eur Respir J

338

276

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Minimally invasive diagnostic and therapeutic approaches in medicine have been applied for a more selective and tailored approach to reduce patients' morbidity and mortality. The efficacy of interventional pulmonology for palliation of patients with central airways obstruction has been established and its curative potential for intralesional treatment of early cancer has raised great interest in current screening programmes. This is due to the fact that surgical resection and systemic nodal dissection as the gold standard is relatively morbid and risky, especially when dealing with individuals with limited functional reserves due to smoking-related comorbidities, such as chronic obstructive pulmonary disease. Furthermore, such comorbidities have been proven to harbour early stage lesions of several millimetres in size without involvement of nodal disease that may be amenable to local bronchoscopic treatment.Therefore, the success of minimally invasive strategies for palliation and treatment with curative intent strongly depends on the diligent identification of the various factors in lung cancer management, including full comprehension of the limits and potential of each particular technique. Maximal preservation of quality of life is a prerequisite in successfully dealing with individuals at risk of harbouring asymptomatic early lung cancer, to prevent aggressive surgical diagnostic and therapeutic strategies since overdiagnosis remains an issue that is heavily debated.In the palliative setting of alleviating central airway obstruction, laser resection, electrocautery, argon plasma coagulation and stenting are techniques that can provide immediate relief, in contrast to cryotherapy, brachytherapy and photodynamic therapy with delayed effects. With curative intent, intraluminal techniques that easily coagulate early stage cancer lesions will increase the implementation of interventional pulmonology for benign and relatively benign diseases, as well as early cancer lesions and its precursors at their earliest stage of disease.

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Section: Clinical Experience and Resultsmentioning

confidence: 99%

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Bolliger¹

2006

Eur Respir J

338

276

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“…The causes of removal were the effectiveness of chemotherapy and/ or radiotherapy in two cancer patients (one appeared with migration), a curative operation in two benign cases, an improvement in one patient's bronchopleural fi stula, 9 increased secretion and cough in three, migration in two, and granulation in one.…”

Section: Resultsmentioning

confidence: 99%

Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula

Mitsuoka

Sakuragi

Itoh

2007

Gen Thorac Cardiovasc Surg

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“…Compared with the modified Y-shaped Dumon stent (with the ipsilateral arm shortened and closed) [5,18,19], the bronchial occluders used in this study have the advantages of a smaller occluder introducer system, less patient discomfort, and no need for a rigid bronchoscope. In addition, the risk of sputum retention or infection could be reduced as the trachea and contralateral bronchus were not affected by the bronchial occluder and the occluder (a) (b) used in this study was placed via the endotracheal route instead of transthoracic route.…”

Section: Discussionmentioning

confidence: 99%

“…Bronchopleural fistulas (BPFs) are rare pathological conditions which may be life-threatening complications with a mortality rate ranging between 11% and 15% [1][2][3][4][5]. BPFs are among the most serious complications after pneumonectomy, the surgical repair of which may be difficult [6].…”

Section: ' 2012 the British Institute Of Radiologymentioning

confidence: 99%

“…BPFs are among the most serious complications after pneumonectomy, the surgical repair of which may be difficult [6]. Many interventional and endoscopic options proposed to close the fistula include injection of tissue adhesives, insertion of modified Dumon stents, and embolisation with vascular occluding coils and glue [2][3][4][5].…”

Section: ' 2012 the British Institute Of Radiologymentioning

confidence: 99%

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Experimental lung collapse following deployment of a self-expandable bronchial occluder in a rabbit model

Cho

Shin

et al. 2012

BJR

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Objectives: Closure of a bronchopleural fistula is required to prevent fatal empyema or aspiration pneumonia. The purpose of this study was to determine the feasibility and efficacy of bronchial occlusion with a self-expandable occluder to induce experimental lung collapse in a rabbit model. Methods: 10 bronchial occluders (wine glass appearance; 8 mm in diameter and 15 mm in length) were implanted in the native left main bronchi of 10 rabbits via an endotracheal route. We analysed the following: (1) diameters and morphological changes of the bronchial occluders during follow-up; (2) percentage volume of the collapsed lung during follow-up; and (3) complications and gross pathology. 1-day and 2-week follow-up CT scans were routinely obtained. Rabbits were sacrificed 4 weeks after the experiment. Results: In all 10 rabbits, the bronchial occluders were successfully implanted and were completely expanded within 2 weeks. Complete collapse of the left lung occurred in three rabbits on day 1 and in an additional two rabbits 2 weeks following implantation. Two other rabbits maintained the percentage volume of the collapsed lung between 51% and 99% during follow-up; the other three rabbits had ,50% during follow-up. Pneumothoraces occurred in nine rabbits, but completely resolved at the 2-week follow-up. Right lung herniation across the midline progressed 2 weeks after occluder implantation. Conclusion: Placement of self-expandable occluders in a rabbit bronchus model was feasible and showed a potential to induce artificial lung collapse. While pneumothoraces were common, they resolved during follow-up.

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Modified Dumon stent for the treatment of a bronchopleural fistula after pneumonectomy

Cited by 43 publications

References 6 publications

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula

Experimental lung collapse following deployment of a self-expandable bronchial occluder in a rabbit model

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