From the Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
Exp Clin Transplant. 2022 Jun;20(6):627-629. doi: 10.6002/ect.2020.0203. Epub 2021 Feb 1.
Segmental nonanastomotic stenosis, also known as vanishing bronchus intermedius syndrome (or simply, "vanishing bronchus"), is a rare complication that can occur after a lung transplant. It usually occurs in the first posttransplant year and often develops in the intermediate bronchus. Definitive diagnosis is established by bronchoscopy. The treatment management primarily includes bronchoscopic dilatation and stenting. In patients who do not benefit from these applications, lung resection or retransplant may be indicated. Our 58-year-old patient developed vanishing bronchus after lung transplant, and recurrence could not be prevented despite repeated bronchoscopic interventions. We applied submucosal mitomycin C injection to the bronchial wall of the stenotic segment and achieved significant benefit for reduction of recurrence. Our aim was to document the first reported case of a patient with vanishing bronchus who was treated with submucosal administration of mitomycin C, a strong fibroblast inhibitor, and to report the outcomes of submucosal mitomycin C administration with regard to recurrence.
节段性非吻合性狭窄，又称中间支气管消失综合征（简称“消失支气管”），是肺移植后罕见的并发症。它通常发生在移植后的第一年，常在中间支气管出现。支气管镜检查可明确诊断。治疗管理主要包括支气管镜扩张和支架置入。对于这些应用无效的患者，可能需要肺切除或再次移植。我们的 58 岁患者在肺移植后出现消失支气管，尽管反复进行支气管镜介入，仍无法防止复发。我们在狭窄段的支气管壁上应用黏膜下丝裂霉素 C 注射，显著减少了复发，取得了显著的获益。我们的目的是报道首例应用黏膜下给予丝裂霉素 C（一种强成纤维细胞抑制剂）治疗消失支气管的患者，并报告黏膜下丝裂霉素 C 给药在减少复发方面的结果。
