Can total bronchopleural fistulas from complete stump dehiscence be endoscopically treated?

Abstract OBJECTIVES: Bronchopleural fistula (BPF) is an uncommon complication following a lung resection to address various conditions. BPFs are associated with high morbidity and mortality rates. This study evaluated the endoscopic treatment of ‘total’ BPFs using the Occlutech-Fígulla® cardiac devi...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2017-04, Vol.51 (4), p.702-708
Main Authors: Scordamaglio, Paulo Rogério, Tedde, Miguel Lia, Minamoto, Hélio, Assad, Renato Samy, Fernandes, Paulo Manuel Pêgo
Format: Article
Language:English
Subjects:
Adult
Aged
Bronchial Fistula - etiology
Bronchial Fistula - surgery
Bronchoscopy - adverse effects
Bronchoscopy - methods
Chronic Disease
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pleural Diseases - etiology
Pleural Diseases - surgery
Pneumonectomy - adverse effects
Prospective Studies
Respiratory Tract Fistula - etiology
Respiratory Tract Fistula - surgery
Septal Occluder Device - adverse effects
Surgical Wound Dehiscence - complications
Treatment Outcome
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Summary:Abstract OBJECTIVES: Bronchopleural fistula (BPF) is an uncommon complication following a lung resection to address various conditions. BPFs are associated with high morbidity and mortality rates. This study evaluated the endoscopic treatment of ‘total’ BPFs using the Occlutech-Fígulla® cardiac device at a single centre. METHODS: We selected nine patients with chronic and complete BPFs. Under direct bronchoscopic visualization, the BPFs were treated using the Occlutech-Fígulla device. The patients were followed up for 12 months to determine the treatment level and complications. RESULTS: The procedure had a favourable outcome in three patients, resulting in complete fistula closure. Two patients had partial closure and showed improvements in their clinical conditions. In two other cases, closure of the bronchial stump was unsuccessful using this method. Two patients died from causes unrelated to the procedure or the device. During the follow-up period, no complications related to infection or device-related injuries were reported. CONCLUSIONS: In patients without clinical conditions that require surgical treatment, the Occlutech-Fígulla cardiac device can be a safe and effective method for the endoscopic treatment of large BPFs resulting from complete dehiscence of a bronchial stump. No severe events were reported.
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezw377