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Amplatzer 封堵器用于支气管胸膜瘘的有效非手术治疗。

Amplatzer Occluders for Effective Nonsurgical Management of Bronchopleural Fistulae.

机构信息

Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel; Sackler Medicine Faculty, Tel Aviv University, Tel Aviv, Israel.

Sackler Medicine Faculty, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesiology, Rabin Medical Center, Petah Tikva, Israel.

出版信息

Ann Thorac Surg. 2024 Jul;118(1):225-232. doi: 10.1016/j.athoracsur.2023.08.031. Epub 2023 Sep 9.

Abstract

BACKGROUND

To assess the safety and efficacy of bronchopleural fistulae closure with Amplatzer occluder devices (AGA Medical, Golden Valley, MN) through our experience of over 14 years.

METHODS

Retrospective data review of patients from Rabin Medical Center who underwent Amplatzer occluder device placement between March 2007 and September 2021 for bronchopleural fistulae closure.

RESULTS

In total, 72 patients had 83 Amplatzer occluder devices implanted for bronchopleural fistulae closure. The median age was 65.5 (interquartile range 56.0-72.3) years. The primary diseases were lung malignancy (48 [66.7%]) and thoracic infection (9 [12.5%]). Bronchopleural fistulae developed mainly following pneumonectomy (40.3%) and lobectomy (33.3%), with a median time from surgery to Amplatzer placement of 3.9 (interquartile range 1.4-16.4) months. We encountered no procedural or immediate postprocedural complications or deaths. Six months after Amplatzer insertion, there were 7 (8.4%) Amplatzer removals and 11 (15.3%) fistula-related deaths.

CONCLUSIONS

Amplatzer occluders are a safe modality for nonsurgical bronchopleural fistulae management with ease of placement under moderate sedation and flexible bronchoscopy with good short- and long-term effectivity.

摘要

背景

通过我们超过 14 年的经验,评估使用 Amplatzer 封堵器(AGA Medical,Golden Valley,MN)闭合支气管胸膜瘘的安全性和疗效。

方法

对 2007 年 3 月至 2021 年 9 月在拉宾医学中心接受 Amplatzer 封堵器置入术以闭合支气管胸膜瘘的患者进行回顾性数据分析。

结果

共 72 例患者共植入 83 个 Amplatzer 封堵器以闭合支气管胸膜瘘。中位年龄为 65.5 岁(四分位距 56.0-72.3)。主要疾病为肺部恶性肿瘤(48 [66.7%])和胸部感染(9 [12.5%])。支气管胸膜瘘主要发生在肺切除术(40.3%)和肺叶切除术(33.3%)后,从手术到 Amplatzer 放置的中位时间为 3.9(四分位距 1.4-16.4)个月。我们未发现任何程序相关或即刻术后并发症或死亡。Amplatzer 置入后 6 个月,有 7 例(8.4%)Amplatzer 取出和 11 例(15.3%)与瘘相关的死亡。

结论

Amplatzer 封堵器是一种安全的非手术性支气管胸膜瘘管理方法,在中度镇静下和灵活的支气管镜下易于放置,具有良好的短期和长期效果。

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