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使用支气管渡边套管进行支气管内栓塞成功治疗肺叶切除术后支气管瘘

Successful treatment of bronchial fistula after pulmonary lobectomy by endobronchial embolization using an endobronchial watanabe spigot.

作者信息

Machida Yuichiro, Tanaka Makoto, Motono Nozomu, Maeda Sumiko, Usuda Katsuo, Sagawa Motoyasu

机构信息

Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahokugun, Ishikawa 920-0293, Japan.

出版信息

Case Rep Pulmonol. 2015;2015:425694. doi: 10.1155/2015/425694. Epub 2015 Apr 15.

Abstract

A bronchial fistula is one of the most serious complications that can occur following pulmonary lobectomy. We herein report a case of bronchial fistula that was successfully treated by endobronchial embolization using an Endobronchial Watanabe Spigot (EWS). A 72-year-old male underwent right lower lobectomy of the lung with nodal dissection for a pulmonary squamous cell carcinoma. A bronchial fistula developed 53 days after surgery. Tube drainage was performed, and air leakage was apparent. Under endoscopic observation, intrathoracic injection of indigo carmine revealed that a fistula existed at the peripheral site of the B(2)ai bronchus. After one EWS (small) was inserted into the B(2)a bronchus tightly using a bronchoscope, the air leakage was stopped. Pleurodesis was further carried out, the thoracostomy tube was subsequently removed, and the patient was discharged. Endobronchial embolization using an EWS is an option for the treatment of a bronchial fistula after pulmonary resection.

摘要

支气管瘘是肺叶切除术后可能发生的最严重并发症之一。我们在此报告一例支气管瘘病例,该病例通过使用渡边支气管栓子(EWS)进行支气管内栓塞成功治愈。一名72岁男性因肺鳞状细胞癌接受了右下肺叶切除及淋巴结清扫术。术后53天发生了支气管瘘。进行了胸腔闭式引流,明显存在漏气。在内镜观察下,胸腔内注射靛胭脂显示在B(2)ai支气管外周部位存在瘘口。使用支气管镜将一枚EWS(小号)紧密插入B(2)a支气管后,漏气停止。进一步进行了胸膜固定术,随后拔除胸腔引流管,患者出院。使用EWS进行支气管内栓塞是肺切除术后支气管瘘治疗的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b39/4413516/e68e45f9fe7c/CRIPU2015-425694.001.jpg

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