Department of Respiratory Centre, The Second Affiliated Hospital of Xiamen Medical College, 566 Shengguang Road, Xiamen, 361000, Fujian Province, China.
BMC Pulm Med. 2021 Jan 6;21(1):10. doi: 10.1186/s12890-020-01372-8.
Bronchopleural fistula is a rare but life-threatening event with limited therapeutic options. We aimed to investigate the efficacy and safety of the modified silicone stent in patients with post-surgical bronchopleural fistula.
Between March 2016 and April 2020, we retrospectively reviewed the records of 17 patients with bronchopleural fistula and who underwent bronchoscopic placement of the Y-shaped silicone stent. The rate of initial success, clinical success and clinical cure, and complications were analyzed.
Stent placement was successful in 16 patients in the first attempt (initial success rate: 94.1%). The median follow-up time was 107 (range, 5-431) days. All patients achieved amelioration of respiratory symptoms. The clinical success rate was 76.5%. Of the 14 patients with empyema, the daily drainage was progressively decreased in 11 patients, and empyema completely disappeared in six patients. Seven stents were removed during follow-up: four (26.7%) for the cure of fistula, two for severe proliferation of granulomatous tissue and one for stent dislocation. No severe adverse events (i.e. massive hemoptysis, suture dehiscence) took place. Seven patients died (due to progression of malignancy, uncontrolled infection, myocardial infarction and left heart failure).
The modified silicone stent may be an effective and safe option for patients with post-surgical bronchopleural fistula patients in whom conventional therapy is contraindicated.
支气管胸膜瘘是一种罕见但危及生命的疾病，治疗选择有限。我们旨在研究改良型硅胶支架在手术后支气管胸膜瘘患者中的疗效和安全性。
在 2016 年 3 月至 2020 年 4 月期间，我们回顾性分析了 17 例接受支气管镜下 Y 型硅胶支架置入术治疗的支气管胸膜瘘患者的病历。分析了初始成功率、临床成功率和临床治愈率以及并发症。
16 例患者在首次尝试中成功放置支架（初始成功率：94.1%）。中位随访时间为 107 天（范围：5-431 天）。所有患者的呼吸症状均得到改善。临床成功率为 76.5%。在 14 例脓胸患者中，11 例患者的每日引流逐渐减少，6 例患者的脓胸完全消失。在随访期间，有 7 个支架被取出：4 个（26.7%）是为了治愈瘘管，2 个是因为肉芽肿组织严重增生，1 个是因为支架移位。没有发生严重的不良事件（即大量咯血、缝线裂开）。7 例患者死亡（由于恶性肿瘤进展、感染失控、心肌梗死和左心衰竭）。
对于因常规治疗禁忌而不能接受治疗的手术后支气管胸膜瘘患者，改良型硅胶支架可能是一种有效且安全的选择。
