Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Department of Thoracic Surgery, International University Health and Welfare School of Medicine, Narita, Japan.
Thorac Cancer. 2023 Aug;14(22):2229-2232. doi: 10.1111/1759-7714.15008. Epub 2023 Jun 20.
Bronchopleural fistulas are rare complications of bevacizumab treatment. Herein, we report a case of bronchopleural fistula after bevacizumab therapy. The patient was a 65-year-old man with lung cancer who underwent a right lower lobectomy with systemic lymph node dissection after induction chemotherapy with bevacizumab. Pathological examination revealed no residual tumor cells in the resected specimen. The patient presented with severe dyspnea on postoperative day 26. Bronchoscopy revealed a bronchopleural fistula in the membranous portion of the right intermediate bronchus; the bronchial stump remained intact. The bronchopleural fistula was repaired with muscle flaps, and bronchoscopy 9 months after surgery showed satisfactory healing of the fistula. The patient has been alive for 5 years without evidence of recurrence. Careful attention must be paid to postoperative management when bevacizumab is used for induction therapy.
支气管胸膜瘘是贝伐珠单抗治疗的罕见并发症。本文报告了 1 例贝伐珠单抗治疗后发生支气管胸膜瘘的病例。患者为 65 岁男性，肺癌，在诱导化疗联合贝伐珠单抗治疗后接受了右肺下叶切除术和系统性淋巴结清扫术。病理检查显示切除标本中无残留肿瘤细胞。患者在术后第 26 天出现严重呼吸困难。支气管镜检查显示右中间支气管膜部有支气管胸膜瘘，支气管残端保持完整。使用肌瓣修复了支气管胸膜瘘，术后 9 个月的支气管镜检查显示瘘口愈合良好。患者存活 5 年，无复发迹象。当贝伐珠单抗用于诱导治疗时，必须注意术后管理。
