Han Young Min, Lee Heung Bum, Jin Gong Yong, Kim Kun Yung
Taehan Yongsang Uihakhoe Chi. 2021 Mar;82(2):371-381. doi: 10.3348/jksr.2020.0027. Epub 2020 Dec 30.
To evaluate the usefulness and effectiveness of bronchial occluders in the treatment of postoperative bronchopleural fistula (BPF).
The subjects of the study were six out of seven postoperative BPF patients who underwent surgery due to tuberculosis or lung cancer between 2009 and 2019. Each patient had a bronchial occluder inserted to treat BPF that occurred after surgery. Of the six patients, five had lung cancers and one had tuberculosis. Five were male and one was female; their ages ranged from 59 to 74 years, with an average of 69 years. The diagnosis of BPF was based on findings from bronchoscopy and CT, and treatment was initiated approximately 1 to 2 weeks after diagnosis. The technical and clinical success of the bronchial occluders in the treatment of BPF was evaluated. The study assessed the postoperative clinical effects of the occluders, survival duration, and additional treatments.
All six patients were successfully treated. Clinical success was achieved in five patients, while partial clinical success was achieved in one; there was no clinical failure. No complications during the migration of the device or device perforations were observed. Two patients were diagnosed with BPF by CT, while four were diagnosed by bronchoscopy. Lobectomy, bilobectomy, and pneumonectomy were performed on two patients each. The periods between surgery and diagnosis ranged from 1 to 34 months; the average was 10 months. Four patients (59-103 days; an average of 80.5 days) died and two (313 days, 3331 days) survived. The causes of death were aggravation of the underlying disease ( = 2), pulmonary edema and pleural effusion ( = 1), and pneumonia ( = 1). Additional catheter drainage was performed in one patient, and a chest tube was maintained in two patients.
Bronchial occluders are useful and effective in the treatment of BPF after pulmonary resection.
评估支气管封堵器在治疗术后支气管胸膜瘘（BPF）中的实用性和有效性。
本研究的对象为2009年至2019年间因结核病或肺癌接受手术的7例术后BPF患者中的6例。每位患者均插入支气管封堵器以治疗术后发生的BPF。6例患者中，5例患有肺癌，1例患有结核病。5例为男性，1例为女性；年龄范围为59至74岁，平均69岁。BPF的诊断基于支气管镜检查和CT结果，并在诊断后约1至2周开始治疗。评估支气管封堵器治疗BPF的技术和临床成功率。该研究评估了封堵器的术后临床效果、生存时间和额外治疗情况。
所有6例患者均成功治疗。5例患者取得临床成功，1例取得部分临床成功；无临床失败病例。未观察到装置迁移过程中的并发症或装置穿孔。2例患者通过CT诊断为BPF，4例通过支气管镜诊断。2例患者分别接受了肺叶切除术、双肺叶切除术和全肺切除术。手术与诊断之间的时间间隔为1至34个月；平均为10个月。4例患者（59 - 103天；平均80.5天）死亡，2例（313天、3331天）存活。死亡原因分别为基础疾病加重（ = 2）、肺水肿和胸腔积液（ = 1）以及肺炎（ = 1）。1例患者进行了额外的导管引流，2例患者留置了胸管。
支气管封堵器在肺切除术后BPF的治疗中是有用且有效的。
