Acta Medica Okayama volume73 issue4
2019-08 発行

Therapeutic Outcomes of 15 Postoperative Bronchopleural Fistulas Including Seven Endoscopic Interventions

Ueno, Tsuyoshi Department of Thoracic Surgery, National Hospital Organization,Shikoku Cancer Center
Maki, Yuho Department of Thoracic Surgery, National Hospital Organization,Shikoku Cancer Center
Sugimoto, Ryujiro Department of Thoracic Surgery, National Hospital Organization,Shikoku Cancer Center
Suehisa, Hiroshi Department of Thoracic Surgery, National Hospital Organization,Shikoku Cancer Center
Yamashita, Motohiro Department of Thoracic Surgery, National Hospital Organization,Shikoku Cancer Center
Harada, Daijiro Department ofThoracic Oncology, National Hospital Organization,Shikoku Cancer Center
Kozuki, Toshiyuki Department ofThoracic Oncology, National Hospital Organization,Shikoku Cancer Center
Nogami, Naoyuki Department ofThoracic Oncology, National Hospital Organization,Shikoku Cancer Center
Publication Date
2019-08
Abstract
Therapeutic approaches to bronchopleural fistula (BPF) closure after lung resection are surgical or endoscopic interventions. We evaluated therapeutic outcomes to determine the optimal approach. We reviewed 15 patients who had developed BPF after lung resection for thoracic malignant diseases at our institution in the 10 years since 2008. The patients were 11 men and 4 women (mean age 68 years). We performed one pneumonectomy, 6 lobectomies, 7 segmentectomies, and one partial resection for malignant diseases. The median interval from lung resection to the BPF diagnosis was 46 days. The BPF-associated mortality rate was 26.7% (4/15). The rate of successful BPF closure was 66.6% (10/15). The endoscopic and surgical intervention success rates were 14.2% (1/7) and 69.2% (9/13), respectively (p<0.01). Of 5 patients who had failed BPF treatments, 4 died, and one transferred out without BPF closure. The therapeutic outcomes were related to preoperative comorbidities, performance status at the BPF diagnosis, time intervals from lung resection to BPF diagnosis, and presence of active pneumonia. The difference between endoscopic and surgical outcomes was nonsignificant, although the surgical intervention success rate was somewhat higher. The selection of endoscopic or surgical intervention for BPF does not significantly affect therapeutic outcomes.
Document Type
Original Article
Keywords
bronchopleural fistula
endoscopic intervention
surgical intervention
Link to PubMed
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