Gursoy Soner, Yapucu Murat U, Ucvet Ahmet, Yazgan Serkan, Basok Oktay, Ermete Sulun
Thoracic Surgery Department, Dr. Suat Seren Chest Disease and Thoracic Surgery Training Hospital, Izmir, Turkey.
Asian Cardiovasc Thorac Ann. 2008 Dec;16(6):450-3. doi: 10.1177/021849230801600604.
Bronchopleural fistula is an important cause of mortality and morbidity after pulmonary resection. The use of fibrin glue to reduce the tension and number of sutures in the bronchial stump was assessed in this prospective study of 20 patients between June 2002 and May 2003. They all had a high risk of bronchopleural fistula development because of bronchiectasis, tuberculosis, lung abscess, diabetes mellitus, preoperative neoadjuvant radiotherapy, or residual tumor at the surgical margin. After pulmonary resection, the bronchial stump was closed with separate nonabsorbable sutures supported with fibrin glue. Bronchopleural fistula was observed in only 1 (5%) patient during 6.45 +/- 3.09 months of follow-up. There was no postoperative mortality. Closing the bronchial stump with an appropriate technique and supporting it with fibrin glue were considered effective in preventing bronchopleural fistula development after pulmonary resection in high-risk patients.
支气管胸膜瘘是肺切除术后死亡率和发病率的重要原因。在这项对20例患者的前瞻性研究中，评估了使用纤维蛋白胶来降低支气管残端缝线的张力和数量。研究时间为2002年6月至2003年5月。由于支气管扩张、肺结核、肺脓肿、糖尿病、术前新辅助放疗或手术切缘残留肿瘤，他们均有发生支气管胸膜瘘的高风险。肺切除术后，用单独的不可吸收缝线闭合支气管残端，并辅以纤维蛋白胶。在6.45±3.09个月的随访期间，仅1例（5%）患者出现支气管胸膜瘘。无术后死亡病例。在高危患者中，采用适当技术闭合支气管残端并辅以纤维蛋白胶被认为可有效预防肺切除术后支气管胸膜瘘的发生。
