The role of interventional pulmonology for the postoperative bronchopleural fistula

Niger J Clin Pract. 2021 May;24(5):633-639. doi: 10.4103/njcp.njcp_614_19.

Abstract

Background: : Postoperative bronchopleural fistula (BPF) remains a serious complication due to its high morbidity and mortality. Although various endoscopic techniques have been defined for the closure of BPF previously, no standard algorithm yet exists.

Aims: To study the effectiveness and safety of various endoscopic procedures in an interventional pulmonology unit.

Materials and methods: The medical data of 15 postoperative BPF patients, who were undergone endoscopic intervention were retrospectively investigated.

Results: The mean size of the fistulas determined by bronchoscopic evaluation was 7.93 ± 3.26 mm (range 3-15 mm). Applied procedures were as follows: stent implantation (n: 8, 53.3%), stent implantation and polidocanol application (n: 4, 26.7%), only Argon Plasma Coagulation (APC) application (n: 2,13.3%), polidocanol application (n: 1,6.7%). Complete fistula closure was achieved in three of the 15 patients (20%). The procedures were partly successful in five (33.3%) patients and failed to be successful in seven (46.6%) patients. Survival rates in regard to procedural success were determined and a statistically significant difference was found in five-year survival rates (P = 0.027, P < 0.05).

Conclusion: Our results demonstrated that bronchoscopic procedures can be safely and effectively performed in patients who were not eligible for surgery for various reasons.

Keywords: Bronchopleural fistula; bronchoscopy; interventional pulmonology.

MeSH terms

  • Bronchial Fistula* / etiology
  • Bronchial Fistula* / surgery
  • Bronchoscopy
  • Humans
  • Pneumonectomy
  • Postoperative Complications / surgery
  • Pulmonary Medicine*
  • Retrospective Studies