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
Endoscopic bronchial occlusion for postoperative persistent bronchopleural fistula with computed tomography fluoroscopy guidance and virtual bronchoscopic navigation: A case report.
作者信息
Yanagiya Masahiro, Matsumoto Jun, Nagano Masaaki, Kusakabe Masashi, Matsumoto Yoko, Furukawa Ryutaro, Ohara Sayaka, Usui Kazuhiro
机构信息
Department of General Thoracic Surgery, NTT Medical Center Tokyo Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine Department of Radiology Division of Respirology, NTT Medical Center Tokyo, Tokyo, Japan.
出版信息
Medicine (Baltimore). 2018 Feb;97(7):e9921. doi: 10.1097/MD.0000000000009921.
RATIONALE
The development of postoperative bronchopleural fistula (BPF) remains a challenge in thoracic surgery. We herein report a case of BPF successfully treated with endoscopic bronchial occlusion under computed tomography (CT) fluoroscopy and virtual bronchoscopic navigation (VBN).
PATIENT CONCERNS
A 63-year-old man underwent right upper lobectomy with concomitant S6a subsegmentectomy for lung adenocarcinoma. On postoperative day 24, he complained of shaking chills with high fever.
DIAGNOSES
BPF with subsequent pneumonia and empyema.
INTERVENTIONS
Despite aggressive surgical interventions for the BPF, air leakage persisted postoperatively. On days 26 and 34 after the final operation, endobronchial occlusions were performed under CT fluoroscopy and VBN.
OUTCOMES
The air leaks greatly decreased and the patient was discharged.
LESSONS
CT fluoroscopy and VBN can be useful techniques for endobronchial occlusion in the treatment of BPF.
原理
术后支气管胸膜瘘（BPF）的发生仍是胸外科面临的一项挑战。我们在此报告一例通过计算机断层扫描（CT）透视和虚拟支气管镜导航（VBN）下的内镜支气管封堵成功治疗BPF的病例。
患者情况
一名63岁男性因肺腺癌接受了右上叶切除并同期行S6a亚段切除术。术后第24天，他出现寒战伴高热。
诊断
BPF伴随后续肺炎和脓胸。
干预措施
尽管对BPF进行了积极的手术干预，但术后仍持续存在漏气。在最后一次手术后的第26天和第34天，在CT透视和VBN下进行了支气管内封堵。
结果
漏气明显减少，患者出院。
经验教训
CT透视和VBN可作为治疗BPF时支气管内封堵的有用技术。
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