Abstract
Bronchopleural fistulas represent a relatively frequent complication of pulmonary resections.This pathology may be treated by different approach depending on morphology,site or dimension of the fistula.An endoscopic less invasive treatment may be desirable but sometimes difficult,depending on the dimensions of the leak.We present a new method proved to be efficient in larger and chronic fistulas.Through a rigid bronchoscope,a small cylinder of PVA(polyvinyl alcohol)sponge is inserted to the fistula and then charged with a very fluid,slow activated cyanoacrylate.The cylinder increases its volume while the cyanoacrylate gradually polymerizes and solidifies,with tight adherence to the walls of the fistula.The immediate result is the occlusion of it,but the sponge also induces inflammatory reaction which brings to a granuloma (Figure1).We treated 7 patients with post resection fistulas ranging from 4 to 8 mm.The site was the bronchial surgical suture in 6/7 patients and in one case the right wall of distal trachea,after N4R lymphectomy.A complete occlusion of the fistulas was achieved in 7/7 patients and a definitive result in 5/7.The procedure took 40±5minutes to be performed.No severe complications occurred after the interventional endoscopic procedures.This new technique may represent an effective treatment in patients with larger fistulas, but also on difficult sites like trachea.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3130.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020
