Zheng A, Yang X, Ye X, Huang G, Wei Z, Wang J, Han X, Ni X, Meng M
Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
Indian J Cancer. 2015 Dec;52 Suppl 2:e41-6. doi: 10.4103/0019-509X.172512.
Bronchopleural fistula (BPF) complicating lung tumor ablation is rare but severe. The purpose of this article was to study its characteristics and treatments.
Two of 682 (0.3%) sessions of lung microwave ablation (MWA) were complicated with BPF and documented. Two electronic databases were searched for reported cases of BPF after lung tumor ablation. Case selection and data collection were done by 3 independent reviewers.
A 56-year-old man and a 61-year-old woman developed BPF after MWA and died. Thirteen cases (mean age 63.8, 61.5% male) of BPF with adequate information were identified from 8 articles. Of the 13 cases, 5 (38.5%) had pulmonary co-morbidity, 3 (23.1%) had a history of pulmonary surgery, 7 (53.8%) had a target tumor adjacent or abutting pulmonary pleura, and 6 (46.2%) developed severe infections. After chest tube placement, pleurodesis, endoscopic therapy, surgery, and other treatments, 12 were cured and 1 died of BPF and pneumonia.
BPF is a rare but severe complication of lung ablation, and the management needs a multidisciplinary and individualized treatment strategy.
支气管胸膜瘘（BPF）作为肺肿瘤消融的并发症较为罕见但病情严重。本文旨在研究其特征及治疗方法。
682例肺微波消融（MWA）治疗中，有2例（0.3%）并发BPF并记录在案。检索两个电子数据库以查找肺肿瘤消融后BPF的报告病例。病例选择和数据收集由3名独立审阅者完成。
一名56岁男性和一名61岁女性在MWA后发生BPF并死亡。从8篇文章中确定了13例有足够信息的BPF病例（平均年龄63.8岁，61.5%为男性）。在这13例病例中，5例（38.5%）有肺部合并症，3例（23.1%）有肺部手术史，7例（53.8%）靶肿瘤邻近或紧贴肺胸膜，6例（46.2%）发生严重感染。经过置胸管、胸膜固定术、内镜治疗、手术及其他治疗后，12例治愈，1例死于BPF和肺炎。
BPF是肺消融罕见但严重的并发症，其处理需要多学科和个体化的治疗策略。
