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支气管镜下经支气管内注入胶水(氰基丙烯酸正丁酯)治疗支气管胸膜瘘

Bronchoscopic management of bronchopleural fistula with intrabronchial instillation of glue (N-butyl cyanoacrylate).

作者信息

Chawla Rakesh K, Madan Arun, Bhardwaj P K, Chawla Kiran

机构信息

Department of Respiratory Medicine, Critical Care and Sleep Disorders, Jaipur Golden Hospital, Rohini, Delhi, India.

出版信息

Lung India. 2012 Jan;29(1):11-4. doi: 10.4103/0970-2113.92350.

DOI:10.4103/0970-2113.92350
PMID:22345907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3276025/
Abstract

CONTEXT

Bronchopleural fistula (BPF) is a communication between the pleural space and bronchial tree.

MATERIALS AND METHODS

A series of 9 cases are reported where BPF was identified and managed with intrabronchial instillation of glue (N-butyl-cyanoacrylate) through a video bronchoscope.

RESULTS

Out of 9 patients the BPF was successfully sealed in 8 cases (88.88%). In 1 patient of postpneumonectomy, the fistula was big, that is >8 mm who had a recurrence after the procedure. In one case of pyopneumothorax the leak reduced slowly and it took us 14 days to remove the intercostal drainage tube. Rest of the patients had a favorable outcome. No complications were observed in a follow-up of 6 months.

CONCLUSIONS

In our opinion, it is a cost-effective, viable, and safe alternative compared with costly, time-consuming, and high-risk surgical procedures.

摘要

背景

支气管胸膜瘘(BPF)是胸膜腔与支气管树之间的一种连通。

材料与方法

报告了一系列9例经视频支气管镜向支气管内注入胶水(N-丁基-氰基丙烯酸酯)来识别和处理支气管胸膜瘘的病例。

结果

9例患者中,8例(88.88%)支气管胸膜瘘成功封闭。在1例肺切除术后患者中,瘘口较大,即>8mm,术后复发。在1例脓气胸患者中,漏液减少缓慢,我们用了14天时间才拔除肋间引流管。其余患者预后良好。随访6个月未观察到并发症。

结论

我们认为,与昂贵、耗时且高风险的外科手术相比,这是一种经济有效、可行且安全的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b1/3276025/130b62e56529/LI-29-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b1/3276025/a4d26f8e29bb/LI-29-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b1/3276025/130b62e56529/LI-29-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b1/3276025/a4d26f8e29bb/LI-29-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5b1/3276025/130b62e56529/LI-29-11-g002.jpg

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Chest. 2005 Dec;128(6):3955-65. doi: 10.1378/chest.128.6.3955.
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Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management.非小细胞肺癌手术中的支气管胸膜瘘:发病率、危险因素及处理
Ann Thorac Cardiovasc Surg. 2001 Dec;7(6):330-6.
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The incidence, etiology, and prevention of postresectional bronchopleural fistula.肺切除术后支气管胸膜瘘的发病率、病因及预防
术后支气管胸膜瘘修补术:手术结果和影响其成功的因素。
Thorac Cancer. 2022 May;13(9):1401-1405. doi: 10.1111/1759-7714.14404. Epub 2022 Apr 7.
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Bronchopleural Fistula as a Complication in a COVID-19 Patient Managed With Endobronchial Valves.COVID-19 患者行支气管内覆膜支架置入术后并发支气管胸膜瘘
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211013215. doi: 10.1177/23247096211013215.
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An atypical complicated left-sided bronchopleural fistula presenting more than seven months after lobectomy.肺叶切除术后七个多月出现的非典型复杂性左侧支气管胸膜瘘。
Respir Med Case Rep. 2020 Apr 19;30:101056. doi: 10.1016/j.rmcr.2020.101056. eCollection 2020.
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Bronchoscopic device closure of postoperative bronchopleural fistulae: Novel devices and innovative techniques.支气管镜设备封堵术后支气管胸膜瘘:新型设备与创新技术
Lung India. 2020 Mar-Apr;37(2):107-113. doi: 10.4103/lungindia.lungindia_179_19.
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Endoscopic bronchial occlusion for postoperative persistent bronchopleural fistula with computed tomography fluoroscopy guidance and virtual bronchoscopic navigation: A case report.计算机断层扫描荧光透视引导及虚拟支气管镜导航下内镜支气管封堵术治疗术后持续性支气管胸膜瘘:一例报告
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