These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Bronchopleural fistula after pneumonectomy: a major challenge.
    Author: Athanassiadi K, Kalavrouziotis G, Bellenis I.
    Journal: Acta Chir Hung; 1999; 38(1):5-7. PubMed ID: 10439084.
    Abstract:
    OBJECTIVE: Bronchopleural fistula (BPF) is a life-threatening complication of pneumonectomy. Its treatment still challenges the thoracic surgeon. We present our 10-year experience in the management of this entity. MATERIAL: From 1986 to 1997, 8 patients with BPF, representing 2.5% of the 315 pneumonectomies performed in the same period, were treated in our Department. All were male, aged 52-74 (mean: 62.5) years. Pneumonectomy (right: 5, left: 3) was undertaken due to lung cancer. BPF occurred within one month postoperatively. RESULTS: No difference in BPF incidence was observed comparing hand suturing and stapling of the bronchial stump. BPF was associated with empyema thoracis (ET) in 5 patients. Methods of management included prolonged chest tube drainage (n = 5), open thoracostomy (n = 3), bronchoscopical injection of fibrin sealant (n = 2), BPF closure through the previous thoracotomy with autologous tissue buttress (n = 2), transternal transpericardial closure of the BPF (n = 1). Two patients died (mortality 25%): one patient treated with chest tube drainage due to myocardial infarction, and the other undergone transternal BPF closure due to sepsis. In the rest 6 patients closure of the BPF was achieved. CONCLUSION: BPF after pneumonectomy continues to be a problem without definite solution at present. Prevention has not been achieved with the use of staples for bronchial stump closure. Small leaks may be scaled endoscopically with fibrin glue. Otherwise, early surgical closure is mandatory, especially when empyema thoracis coexists.
    [Abstract] [Full Text] [Related] [New Search]