Precht Lisa M, Vallières Eric
Section of Thoracic Surgery, Surgical Services, Swedish Cancer Institute, Seattle, Washington, USA.
Ann Thorac Surg. 2008 Jun;85(6):2116-8. doi: 10.1016/j.athoracsur.2007.12.026.
Bronchopleural fistula is a major cause of morbidity and mortality after pulmonary resection. Different techniques of reinforcing the bronchial stump to prevent this complication have been described. Pledgeted sutures have been suggested for this purpose but have the potential to erode into the bronchus years after resection. We report an unusual case of airway obstruction 13 years after lung resection where pledgeted sutures had been used to reinforce a lobectomy stump. Bronchoscopic management of this rare complication consisted of endobronchial débridement and placement of a silicon stent to allow remodeling of the stenotic airway.
支气管胸膜瘘是肺切除术后发病和死亡的主要原因。已经描述了多种加固支气管残端以预防这种并发症的技术。有人建议使用带垫片缝线来达到这一目的,但在切除多年后有侵蚀支气管的可能。我们报告了一例肺切除术后13年出现气道梗阻的罕见病例,该病例曾使用带垫片缝线加固肺叶切除残端。对这种罕见并发症的支气管镜处理包括支气管内清创和置入硅支架,以使狭窄气道重塑。