Postoperative Bronchopleural Fistula: A Conservative Way of Treatment in Selected Cases

Thorac Cardiovasc Surg. 2021 Sep;69(6):577-579. doi: 10.1055/s-0040-1721676. Epub 2021 Jan 18.

Abstract

Background: Postoperative bronchopleural fistula represents a challenging issue for thoracic surgeons. The treatment options reported include bronchoscopic or surgical procedures but the method yielding the best results remains unclear.

Methods: In our thoracic surgery department, between January 2011 and June 2020, 11 patients treated conservatively for early bronchopleural fistula after lobectomy or bilobectomy were reviewed. The fistula size ranged between 2 and 3 mm and complete suture dehiscence.

Results: In all 11 patients favorable conditions such as clinical stability, complete expansion of the remaining lung, and resolution of the pleural infection allowed a successful conservative treatment with chest tube drainage.

Conclusion: In selected cases, conservative management of early bronchopleural fistula after lobectomy or bilobectomy may be an alternative therapeutic option to bronchoscopic or surgical procedures, regardless of the fistula size.

MeSH terms

  • Aged
  • Bronchial Fistula / etiology
  • Bronchial Fistula / therapy*
  • Chest Tubes
  • Conservative Treatment* / adverse effects
  • Conservative Treatment* / instrumentation
  • Drainage / instrumentation
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymph Node Excision / adverse effects*
  • Male
  • Middle Aged
  • Pleural Diseases / etiology
  • Pleural Diseases / therapy*
  • Pneumonectomy / adverse effects*
  • Respiratory Tract Fistula / etiology
  • Respiratory Tract Fistula / therapy*
  • Therapeutic Irrigation
  • Treatment Outcome