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Bronchopleural fistula after pneumonectomy

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Abstract

Background Bronchopleural fistula (BPF) is an infrequent but life-threatening complication after lung resection. The incidence of BPF reported in the literature varies between 0 and 15%.

Aim To evaluate the incidence of BPF after pneumonectomy for primary lung cancer in a single practice using a single technique.

Methods Hospital records of patients who underwent pneumonectomy from 1 January 1988 to 1 October 1998 were reviewed retrospectively. The bronchial stump was closed using a uniform hand suture technique. There was a total of 157 patients, including 118 males and 39 females with a mean age of 64 years (range 37–78). Sixty-two patients (39.5%) had a right pneumonectomy.

Results Three patients developed BPF (1.9%). All occurred within seven days of the operation. Two of the three patients died. Ventilation for more than 24 hours was found to be the only significant risk factor for the development of BPF (p<0.001).

Conclusions Hand suture closure of bronchial stump after pneumonectomy is a safe, reproducible and inexpensive technique, and a low incidence of BPF can be achieved.

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References

  1. Sweet RH. Closure of the bronchial stump following lobectomy or pneumonectomy.Surgery 1945; 18: 82–4.

    Google Scholar 

  2. Amosov NM, Berezovsky KK. Pulmonary resection with mechanical suture.J Thorac Cardiovasc Surg 1961; 41: 325–5.

    PubMed  CAS  Google Scholar 

  3. Malave G, Foster ED, Wilson JA, Munro DD. Bronchopleural fistula. Present day study of an old problem.Ann Thorac Surg 1971; 11: 1–10.

    PubMed  CAS  Google Scholar 

  4. Kirsh MM, Rotman H, Behrendt DM, Orringer MB, Sloan H. Complications of pulmonary resection.Ann Thorac Surg 1975; 20: 215–36.

    PubMed  CAS  Google Scholar 

  5. Lynn RB. The bronchus stump.J Thorac Surg 1958; 36: 70–5.

    PubMed  CAS  Google Scholar 

  6. Hankins JR, Miller JE, Attar S, Satterfield JR, McLaughlin JS. Bronchopleural fistula: 13 year experience with 77 cases.J Thorac Cardiovasc Surg 1978; 76: 755–60.

    PubMed  CAS  Google Scholar 

  7. Asamura H, Naruke T, Tsuchiya R et al. Bronchopleural fistulas associated with lung cancer operations: univariate and multivariate analysis of risk factors, management and outcome.J Thorac Cardiovasc Surg 1992; 104: 1456–64.

    PubMed  CAS  Google Scholar 

  8. Wright CD, Wain JC, Mathisen DJ, Grillo HC. Post pneumonectomy b ronchopleural fistula after sutured bronchial closure: incidence, risk factors and management.J Thorac Cardiovasc Surg 1996; 112: 1367–71.

    Article  PubMed  CAS  Google Scholar 

  9. Hakim M, Milstein BB. Role of automatic staplers in the aetiology of b ronchopleural fistula.Thorax 1985; 40: 27–31.

    PubMed  CAS  Google Scholar 

  10. Peterffy A, Calabrese E. Mechanical and conventional manual sutures of the b ronchial stump: a comparative study of 298 surgical patients.Scand J Thorac C a rdiovasc Surg 1979; 13: 87–91.

    CAS  Google Scholar 

  11. Kaplan DK, Whyte RI, Donnelly RD. Pulmonary resection using automatic stapling devices.Eur J Cardiothorac Surg 1987; 1: 152.

    Article  PubMed  CAS  Google Scholar 

  12. Al-Kattan K, Cattalani L, Goldstraw P. Bronchopleural fistula after pneumonectomy with a hand suture technique.Ann Thorac Surg 1994; 58: 1433–6.

    PubMed  CAS  Google Scholar 

  13. Sarsam M, Moussali H. Technique of bronchial closure after pneumonectomy.J Thorac Cardiovasc Surg 1989; 98: 220–3.

    PubMed  CAS  Google Scholar 

  14. Forrester-Wood CP. Bronchopleural fistula following pneumonectomy for carcinoma of the bronchus.J Thorac Cardiovasc Surg 1980; 80: 406–9.

    PubMed  CAS  Google Scholar 

  15. Hood RM, Kirskey TD, Calhoon JH, Arnold HS, Tate RS. The use of automatic stapling devices in pulmonary resection.Ann Thorac Surg 1973; 16: 85–95.

    PubMed  CAS  Google Scholar 

  16. Dart CH, Scott SM, Takaro T. Six year clinical experience using automatic stapling devices for lung resections.Ann Thorac Surg 1970; 9: 535–47.

    PubMed  Google Scholar 

  17. Mohsin H, Milstein BB. Role of automatic staplers in the aetiology of bronchopleural fistula.Thorax 1985; 40: 27–31.

    Article  Google Scholar 

  18. Kirskey TD, Arnold HS, Calhoon JH, Hood RM. Technique of pulmonary resection. Tradition and travail.Ann Thorac Surg 1970; 9: 525–34.

    Google Scholar 

  19. Scott RN, Faraci RP, Goodman DG et al. The role of inflammation in bronchial stump healing.Ann Surg 1975; 181: 381–5.

    PubMed  CAS  Google Scholar 

  20. Lawrence GH, Ristroph R, Wood JA, Starr A. Methods for avoiding a dire surgical complication: b ronchopleural fistula after pulmonary resection.Am J Surg 1982; 144: 136–44.

    Article  PubMed  CAS  Google Scholar 

  21. Vester R, Penfield Faber L, Kittle F, Warren WH, Jensik RJ. B ronchopleural fistula after stapled closure of bronchus.Ann Thorac Surg 1991; 52: 1253–8.

    Article  PubMed  CAS  Google Scholar 

  22. Hubaut JJ, Baron O, Al Habash O et al. Closure of the bronchial stump by manual suture closure and incidence of bronchopleural fistula in a series of 209 pneumonectomies for lung cancer.Eur J Cardiothorac Surg 1999; 16: 418–23.

    Article  PubMed  CAS  Google Scholar 

  23. O’Meara JB, Slade PR. Disappearance of fluid from postpneumonectomy space.J Thorac Cardiovasc Surg 1974; 67: 621–8.

    PubMed  CAS  Google Scholar 

  24. de la Riviere AB, Defauw JJ, Knaepen PJ et al. Transsternal closure of bronchopleural fistula after pneumonectomy.Ann Thorac Surg 1997; 64: 954–7.

    Article  PubMed  Google Scholar 

  25. Graham EA, Singer JJ. Successful removal of entire lung for carcinoma of the bronchus.J Am Med Assoc 1933; 101: 1371–4.

    Google Scholar 

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Javadpour, H., Sidhu, P. & Luke, D. Bronchopleural fistula after pneumonectomy. Ir J Med Sci 172, 13–15 (2003). https://doi.org/10.1007/BF02914778

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