[Clinical analysis for bronchopleural fistula after lung resections]

Abstract

To explore the risk factors, preventive measures and therapeutic methods for bronchopleural fistula (BPF) after lung resections. Methods: A restrospective analysis for 11 patients with BPF after pneumonectomy from April 2012 to June 2016 in Department of Thoracic Surgery, Xiangya Hospital, Central South University was performed. Their clinical characteristics, treatment and prognosis were analyzed, and the risk factors and effective therapeutic strategies were summarized. Results: Among the 11 patients with BPF, 10 cases were cured finally, and 1 case with conservative treatment was dead. The total mortality rate was 9.09%. The 10 patients treated with positive measures were all cured, including 5 cases with pulmonary lobectomy and pneumonectomy, 4 cases with amplatzer and covered stent, and 1 case with fibrin glue. One case with conservative treatment was dead because of respiratory failure. Conclusion: It is important to intervene BPF as early as possible. Fibrin glue via bronchoscope for tiny BPF after lung resection is preferred to be considered. We recommend to take early positive operation (pulmonary lobectomy and pneumonectomy) after pulmonary resection if the BPF cannot be cured via bronchoscope whereas the patients' condition is allowed. The amplatzer or covered stent should be considered first for the patient with BPF after pneumonectomy.