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Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success
Background The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success. Methods We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural f...
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| Published in: | Thoracic cancer 2022-05, Vol.13 (9), p.1401-1405 |
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| container_title | Thoracic cancer |
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| creator | Yang, Young Ho Park, Seong Yong Kim, Ha Eun Park, Byung Jo Lee, Chang Young Lee, Jin Gu Kim, Dae Joon Paik, Hyo Chae |
| description | Background
The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success.
Methods
We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity.
Results
Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p |
| doi_str_mv | 10.1111/1759-7714.14404 |
| format | article |
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The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success.
Methods
We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity.
Results
Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07).
Conclusions
There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair.
Mechanical ventilation at the time of BPF (HR, 16.65; 95% CI: 3.02–140.43; p = 0.003) repair was related to failure of BPF repair. The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07). The success rate of BPF is relative to the use of mechanical ventilation at the time of BPF repair and reinforcement tissue.</description><identifier>ISSN: 1759-7706</identifier><identifier>EISSN: 1759-7714</identifier><identifier>DOI: 10.1111/1759-7714.14404</identifier><identifier>PMID: 35393787</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Bronchial Fistula - etiology ; Bronchial Fistula - surgery ; bronchopleural fistula ; Connective tissue diseases ; Diabetes ; Fistula ; Hospitals ; Humans ; Lung cancer ; Lung diseases ; lung transplant ; Lung transplants ; mechanical ventilation ; Mortality ; omental flap ; Original ; Ostomy ; Patients ; Pleural Diseases - etiology ; Pleural Diseases - surgery ; Pneumonectomy ; Pneumonectomy - adverse effects ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Pulmonary fibrosis ; pulmonary resection ; Retrospective Studies ; Risk factors ; Steroids ; Surgical outcomes ; Surgical techniques ; Thoracic surgery ; Treatment Outcome</subject><ispartof>Thoracic cancer, 2022-05, Vol.13 (9), p.1401-1405</ispartof><rights>2022 The Authors. published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.</rights><rights>2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5334-99ce23506b658c8f6bd6b350d9d9453c4dbf32ac87ae9f79aa99d1fb3db377643</citedby><cites>FETCH-LOGICAL-c5334-99ce23506b658c8f6bd6b350d9d9453c4dbf32ac87ae9f79aa99d1fb3db377643</cites><orcidid>0000-0002-2404-9357 ; 0000-0002-2182-010X ; 0000-0001-9240-2215 ; 0000-0003-2767-6505 ; 0000-0001-9309-8235 ; 0000-0002-5180-3853 ; 0000-0002-0977-0525</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2658048842/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2658048842?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,74998</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35393787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Young Ho</creatorcontrib><creatorcontrib>Park, Seong Yong</creatorcontrib><creatorcontrib>Kim, Ha Eun</creatorcontrib><creatorcontrib>Park, Byung Jo</creatorcontrib><creatorcontrib>Lee, Chang Young</creatorcontrib><creatorcontrib>Lee, Jin Gu</creatorcontrib><creatorcontrib>Kim, Dae Joon</creatorcontrib><creatorcontrib>Paik, Hyo Chae</creatorcontrib><title>Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success</title><title>Thoracic cancer</title><addtitle>Thorac Cancer</addtitle><description>Background
The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success.
Methods
We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity.
Results
Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07).
Conclusions
There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair.
Mechanical ventilation at the time of BPF (HR, 16.65; 95% CI: 3.02–140.43; p = 0.003) repair was related to failure of BPF repair. The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07). The success rate of BPF is relative to the use of mechanical ventilation at the time of BPF repair and reinforcement tissue.</description><subject>Bronchial Fistula - etiology</subject><subject>Bronchial Fistula - surgery</subject><subject>bronchopleural fistula</subject><subject>Connective tissue diseases</subject><subject>Diabetes</subject><subject>Fistula</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>lung transplant</subject><subject>Lung transplants</subject><subject>mechanical ventilation</subject><subject>Mortality</subject><subject>omental flap</subject><subject>Original</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Pleural Diseases - etiology</subject><subject>Pleural Diseases - surgery</subject><subject>Pneumonectomy</subject><subject>Pneumonectomy - adverse effects</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Pulmonary fibrosis</subject><subject>pulmonary resection</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Steroids</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><subject>Thoracic surgery</subject><subject>Treatment Outcome</subject><issn>1759-7706</issn><issn>1759-7714</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqFks9vFCEUgCdGY5vaszdD4sXLtjDAAB5Mmo0_mjTRxHomb-DNls3sMMLMmv73sp26sV7kArz38QXeo6peM3rByrhkSpqVUkxcMCGoeFadHiPPj2vanFTnOW9pGVwbWsuX1QmX3HCl1WnVfot5iiMmmMIeSZvi4O7i2OOcoCddyNPcA0k4Qkjvyfc5bYIriThPLu4wExg8Ab_HlJF04KaYMuliImHKJM_OYc6vqhcd9BnPH-ez6senj7frL6ubr5-v11c3Kyc5FytjHNZc0qZtpHa6a1rftGXvjTdCcid82_EanFaAplMGwBjPupb7livVCH5WXS9eH2FrxxR2kO5thGAfAjFtLKQpuB4tNtS5mmn0KAWCAi9RKFaDYK4TyhfXh8U1zu0OvcNhKvV4In2aGcKd3cS9NVRqTnkRvHsUpPhzxjzZXcgO-x4GjHO2dSO0NkrXrKBv_0G3cU5DKVWhpKYFFHWhLhfKpZhzwu54GUbt4TvYQ8Ptofn24TuUE2_-fsOR_9P8AsgF-BV6vP-fz96urxbxb8vTwWI</recordid><startdate>202205</startdate><enddate>202205</enddate><creator>Yang, Young Ho</creator><creator>Park, Seong Yong</creator><creator>Kim, Ha Eun</creator><creator>Park, Byung Jo</creator><creator>Lee, Chang Young</creator><creator>Lee, Jin Gu</creator><creator>Kim, Dae Joon</creator><creator>Paik, Hyo Chae</creator><general>John Wiley & Sons Australia, Ltd</general><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2404-9357</orcidid><orcidid>https://orcid.org/0000-0002-2182-010X</orcidid><orcidid>https://orcid.org/0000-0001-9240-2215</orcidid><orcidid>https://orcid.org/0000-0003-2767-6505</orcidid><orcidid>https://orcid.org/0000-0001-9309-8235</orcidid><orcidid>https://orcid.org/0000-0002-5180-3853</orcidid><orcidid>https://orcid.org/0000-0002-0977-0525</orcidid></search><sort><creationdate>202205</creationdate><title>Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success</title><author>Yang, Young Ho ; Park, Seong Yong ; Kim, Ha Eun ; Park, Byung Jo ; Lee, Chang Young ; Lee, Jin Gu ; Kim, Dae Joon ; Paik, Hyo Chae</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5334-99ce23506b658c8f6bd6b350d9d9453c4dbf32ac87ae9f79aa99d1fb3db377643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bronchial Fistula - etiology</topic><topic>Bronchial Fistula - surgery</topic><topic>bronchopleural fistula</topic><topic>Connective tissue diseases</topic><topic>Diabetes</topic><topic>Fistula</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>lung transplant</topic><topic>Lung transplants</topic><topic>mechanical ventilation</topic><topic>Mortality</topic><topic>omental flap</topic><topic>Original</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Pleural Diseases - etiology</topic><topic>Pleural Diseases - surgery</topic><topic>Pneumonectomy</topic><topic>Pneumonectomy - adverse effects</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Pulmonary fibrosis</topic><topic>pulmonary resection</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Steroids</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><topic>Thoracic surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Young Ho</creatorcontrib><creatorcontrib>Park, Seong Yong</creatorcontrib><creatorcontrib>Kim, Ha Eun</creatorcontrib><creatorcontrib>Park, Byung Jo</creatorcontrib><creatorcontrib>Lee, Chang Young</creatorcontrib><creatorcontrib>Lee, Jin Gu</creatorcontrib><creatorcontrib>Kim, Dae Joon</creatorcontrib><creatorcontrib>Paik, Hyo Chae</creatorcontrib><collection>Wiley Open Access</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Thoracic cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Young Ho</au><au>Park, Seong Yong</au><au>Kim, Ha Eun</au><au>Park, Byung Jo</au><au>Lee, Chang Young</au><au>Lee, Jin Gu</au><au>Kim, Dae Joon</au><au>Paik, Hyo Chae</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success</atitle><jtitle>Thoracic cancer</jtitle><addtitle>Thorac Cancer</addtitle><date>2022-05</date><risdate>2022</risdate><volume>13</volume><issue>9</issue><spage>1401</spage><epage>1405</epage><pages>1401-1405</pages><issn>1759-7706</issn><eissn>1759-7714</eissn><abstract>Background
The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success.
Methods
We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity.
Results
Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07).
Conclusions
There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair.
Mechanical ventilation at the time of BPF (HR, 16.65; 95% CI: 3.02–140.43; p = 0.003) repair was related to failure of BPF repair. The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07). The success rate of BPF is relative to the use of mechanical ventilation at the time of BPF repair and reinforcement tissue.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>35393787</pmid><doi>10.1111/1759-7714.14404</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-2404-9357</orcidid><orcidid>https://orcid.org/0000-0002-2182-010X</orcidid><orcidid>https://orcid.org/0000-0001-9240-2215</orcidid><orcidid>https://orcid.org/0000-0003-2767-6505</orcidid><orcidid>https://orcid.org/0000-0001-9309-8235</orcidid><orcidid>https://orcid.org/0000-0002-5180-3853</orcidid><orcidid>https://orcid.org/0000-0002-0977-0525</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bronchial Fistula - etiology Bronchial Fistula - surgery bronchopleural fistula Connective tissue diseases Diabetes Fistula Hospitals Humans Lung cancer Lung diseases lung transplant Lung transplants mechanical ventilation Mortality omental flap Original Ostomy Patients Pleural Diseases - etiology Pleural Diseases - surgery Pneumonectomy Pneumonectomy - adverse effects Postoperative Complications - etiology Postoperative Complications - surgery Pulmonary fibrosis pulmonary resection Retrospective Studies Risk factors Steroids Surgical outcomes Surgical techniques Thoracic surgery Treatment Outcome |
| title | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
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