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Role of Bronchoscopy in Management of Bronchopleural Fistula

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Interventional Bronchoscopy

Part of the book series: Respiratory Medicine ((RM,volume 10))

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Abstract

Bronchopleural fistula (BPF) refers to a direct communication between the bronchial tree and pleural space. Lung resection is the most common cause of bronchopleural fistula. Other common causes include pulmonary infections, tuberculosis, spontaneous pneumothorax, and trauma. BPF is one of the most serious complications of lung surgery, associated with high morbidity and mortality. Chest computed tomography (CT) and bronchoscopy are useful in establishing diagnosis, identifying the cause and localization of fistulous track. The management of BPF is difficult and depends on underlying cardiopulmonary reserve, nutritional status, fitness to undergo a major surgical procedure, expertise available, and the size and location of fistula. Patients with >5 mm sized centrally located fistula are most likely to benefit from surgery. Several bronchoscopic techniques have also been described for management of BPF. Bronchoscopic interventions may be considered for ≤5 mm peripheral BPF, especially in debilitated and high-surgical-risk patients. In recent years, endobronchial valves have successfully resolved BPF in many such patients.

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Authors and Affiliations

  1. Respirology Division, Medical Institute, Sheikh Khalifa Medical City, Karama Street, Abu Dhabi, 51900, United Arab Emirates

    Yaser Abu El-Sameed M.B.B.S.

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  1. Yaser Abu El-Sameed M.B.B.S.
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Correspondence to Yaser Abu El-Sameed M.B.B.S. .

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  1. , Pulmonary, Allergy and Critical Care Med, Cleveland Clinic, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Atul Mehta

  2. , Pulmonary and Critical Care Medicine, Louis A. Johnson VAMC, Medical Center Drive 1, West Virginia, 26301, USA

    Prasoon Jain

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El-Sameed, Y.A. (2013). Role of Bronchoscopy in Management of Bronchopleural Fistula. In: Mehta, A., Jain, P. (eds) Interventional Bronchoscopy. Respiratory Medicine, vol 10. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-395-4_12

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