RT Journal Article
SR Electronic
T1 Endoscopic and conservative management of post-lobectomy and pneumonectomy bronchopleural fistula
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P487
VO 44
IS Suppl 58
A1 Leonello Fuso
A1 Francesco Varone
A1 Dania Nachira
A1 Ilaria Leli
A1 Ivano Salimbene
A1 Maria Teresa Congedo
A1 Stefano Margaritora
A1 Pierluigi Granone
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P487.abstract
AB Bronchopleural fistula is a rare but potentially fatal complication of pulmonary resections and proper management is essential for its resolution. In this retrospective study, we analyzed the incidence of fistula after lobectomy and pneumonectomy and report our experience with endoscopic and conservative managements. From January 2003 to December 2013, 835 patients underwent anatomic lung resections: 786 (94.2%) lobectomy and 49 (5.8%) pneumonectomy. Bronchopleural fistula was suspected by clinical signs and symptoms and confirmed by endoscopic visualization. Eighteen patients (2.6%) developed a bronchopleural fistula, 11 in lobectomy group (1.3%) and 7 in pneumonectomy group (14.3%). The fistula size ranged between 1 and 6 mm. Mean time of fistula onset was 33.9 ± 54.9 days (1-190) after surgery. All 18 patients were treated with a conservative therapy that consisted in keeping or replacing a drainage chest tube. However, one patient died due to acute respiratory failure and another one was reoperated and then died to causes unrelated to the treatment. Of the remaining 16 patients, 9 underwent also endoscopic closure of fistula using synthetic or biological glues. The mean period of time elapsed for the resolution of this complication was shorter with combined (conservative + endoscopic) than with conservative treatment (15.4 ± 13.2 vs 25.8 ± 13.2 days, respectively), but without statistically significant difference between the two methods (p: NS). In conclusion, conservative treatment eventually associated to an endoscopic therapy is a safe and useful option in the management of the postoperative bronchopleural fistula.