Kowalewski J, Brocki M, Galikowski M, Kapron K
Dept. of General Surgery, University Hospital of the Military Medical Academy, Lódz, Poland.
Acta Chir Hung. 1999;38(1):79-81.
The aim of the paper is to report our surgical technique applied for treatment of broncho-pleural fistula (BPF) as well as the results of the treatment. From 1992 to 1998 we performed 127 pneumonectomies for lung cancer. In 5 cases (3.9%) bronchial stump insufficiency developed postoperatively. Three patients were treated by means of videothoracoscopy (the Multifire Endo Hernia Stapler was used to clipped the fistula). Rethoracotomy with myoplasty was performed four times in 3 patients. In one patient both the methods were employed. In 2 out of 3 cases videothoracoscopic treatment was successful and the patients were discharged without signs of BPF and pleural empyema. In one case the recurrence of the fistula occurred and the stump of the bronchus was successfully covered with the pectoral musce flap 3 days later. In two cases after rethoracotomy and myoplasty (one of them was reoperated twice) the recurrence of BPF occurred and both the patients died due to cardiopulmonary failure. Despite the limited experience, we think videothoracoscopy is worth considering as a tool for treatment of BPF.
本文旨在报告我们用于治疗支气管胸膜瘘（BPF）的手术技术以及治疗结果。1992年至1998年，我们对肺癌患者实施了127例肺切除术。术后有5例（3.9%）出现支气管残端闭合不全。3例患者接受了电视胸腔镜治疗（使用Multifire Endo Hernia吻合器夹闭瘘口）。3例患者中有4次进行了开胸肌成形术。1例患者两种方法都采用了。3例中有2例电视胸腔镜治疗成功，患者出院时无BPF和胸膜脓胸迹象。1例瘘口复发，3天后支气管残端成功被胸肌瓣覆盖。2例开胸肌成形术后（其中1例再次手术）BPF复发，2例患者均死于心肺功能衰竭。尽管经验有限，但我们认为电视胸腔镜作为治疗BPF的一种手段值得考虑。
