Advertisement

Postpneumonectomy Bronchial Fistula

  • F. J. Garcia Diaz
  • J. Ayarra Jarnes
  • A. Rico Alvarez
  • R. Jiménez Mercán
  • C. Arenas Linares
  • J. M. Cuaresma Ferrete
  • J. Loscertales

Abstract

A total of 53 postpneumonectomy bronchial fistulae (PBF) were examined: 37 on the right side (out of 136 pneumonectomies) and 16 on the left side (out of 142). Of these 23 (8%) were precocious (i.e., occurring during the first 10 days) and 30 (10.8%) were late. In 9 cases the PBF appeared 3 months after intervention. The etiological factors comprise the state of the tumor, artificial respiration, kind of bronchial suture, and infection. The latter factor was more influential in the appearance of late PBF: 16 PBFs (30%) appeared without previous infection of the pneumatic cavity, and 22 infections occurred in this area without the appearance of PBF. A total of 155 surgical procedures were carried out (median 2.9, range 1–5). In our series 28 patients (13%) were cured, 8 (15%) survived with PBF well tolerated, and 17 died. We conclude that a diagnosis and early and aggressive surgical treatment are necessary to improve results.

Keywords

Fibrin Glue Fibrin Sealing Bronchopleural Fistula Artificial Respiration Pleural Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abrashanoff (1911) Plastische Methode der Schließung von Fistelgängen, welche von inneren Organen kommen. Zentralbi Chir 38: 186–191Google Scholar
  2. 2.
    Robinson S (1916) The treatment of chronic non-tuberculous empyema. Surg Gynecol Obstet 22: 557–571Google Scholar
  3. 3.
    Clagget OT, Geraci JF (1961) A procedure for the management of postpneumectomy empyema. J Thorac Cardiovasc Surg 63: 771–775Google Scholar
  4. 4.
    Pairolero PC, Arnold PG, Trastek VF, Meland NB, Kay PP (1990) Postpneumectomy empyema. The role of intrathoracic muscle transposition. J Thorac Cardiovasc Surg 99: 958–969Google Scholar
  5. 5.
    Arnold PG, Pairolero PC (1990) Intrathoracic muscle flaps. Ann Surg 211 (6): 656–662PubMedCrossRefGoogle Scholar
  6. 6.
    Abruzzini P (1961) Trattamento delle fistule del bronco principale consecutive a pneumonectomia per tuberculosi. Chir Tor 14: 165–171Google Scholar
  7. 7.
    Dahan M, Regnard JF, Berjaud J, Levasseur PH (1990) Prophylaxis and management of postpneumonectomy empyemas. In: Deslauries J, Lacquet LK (eds) Thoracic surgery: surgical management of pleural disease. Int. Trends Gen Thorac Surg 6: 290–291Google Scholar
  8. 8.
    Beltrami V (1989) Surgical transsternal treatment of bronchopleural fistula postpneumonectomy. Chest 95: 379–382PubMedCrossRefGoogle Scholar
  9. 9.
    Pairolero PC, Arnold PG (1980) Bronchopleural fistula: treatment by transposition of pectoralis major muscle. J Thorac Cardiovasc Surg 79: 142–149PubMedGoogle Scholar
  10. 10.
    Jungiger TH, Walgenbach S, Piehlamier H (1989) Maschinelles und manuelles Bronchusverschlußergebnis einer konsekutiven Untersuchungsserie. Langenbecks Arch Chir 374: 323–328CrossRefGoogle Scholar
  11. 11.
    Jessen C, Sharman P (1985) Use of fibrin glue in thoracic surgery. Ann Thorac Surg 39: 521–526PubMedCrossRefGoogle Scholar
  12. 12.
    Jibah ENG, Sabaratnam S (1989) Tissue adhesive in bronchial closure. Ann Thorac Surg 48: 683–685CrossRefGoogle Scholar
  13. 13.
    Sarsam MAI, Moussali H (1989) Technique of bronchial closure after pneumonectomy. J Thorac Cardiovasc Surg 98: 220–223PubMedGoogle Scholar
  14. 14.
    York EL, Lewall DB, Hirji M, Gelfand ET, Modry DL (1990) Endoscopie and treatment of postoperative bronchopleural fistula. Chest 97: 1390–1392PubMedCrossRefGoogle Scholar
  15. 15.
    Pairolero PC, Arnold PG (1989) Intrathoracic transfer of flaps for fistulas, exposed prosthetic devices and reinforcement of suture lines. Surg Clin North Am 5: 1047–1059Google Scholar
  16. 16.
    Gaud C (1987) Role of mechanical ventilation in the genesis of empyema and bronchopleural fistula. In: Major challenges for the thoracic surgeon. Mosby, St. Louis, pp 447–451 (International trends in general thoracic surgery, vol 2)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • F. J. Garcia Diaz
  • J. Ayarra Jarnes
  • A. Rico Alvarez
  • R. Jiménez Mercán
  • C. Arenas Linares
  • J. M. Cuaresma Ferrete
  • J. Loscertales

There are no affiliations available

Personalised recommendations