Ma Mingxi, Xie Daomin, Zhang Lihui, Li Mengli, Meng Qiu, Xu Shuanglan, Xing Xiqian
Department of Pulmonary and Critical Care Medicine, the Affiliated Hospital of Yunnan Medical University, Key Laboratory of Respiratory Disease Research of Department of Education of Yunnan Province, Kunming, 650021, People's Republic of China.
Clinical Medical College of Dali University, Dali, Yunnan, 671000, People's Republic of China.
Cancer Manag Res. 2024 Dec 21;16:1851-1861. doi: 10.2147/CMAR.S490981. eCollection 2024.
Bronchopleural Fistula (BPF) represents one of the gravest complications post-lobectomy. Present treatment strategies encompass a wide array of surgical techniques complemented by essential adjunct therapies. Despite numerous treatment modalities, mortality rates associated with BPF remain disconcertingly high. Advances in bronchoscopic technology have led to the widespread adoption of bronchoscopic interventions, celebrated for their safety, minimal invasiveness, and efficacy. The cornerstone of BPF management involves the use of sealants, metal-covered stents, and occlusion devices, with the success of these occlusions critically dependent on the fistula's dimensions. Particularly for expansive BPFs deemed inappropriate for surgical intervention, metal-covered stents and occlusion devices are frequently favored. This review critically assesses the therapeutic efficacy and clinical utility of metal-covered stents and occlusion devices through a comprehensive analysis of the extant literature. Additionally, it outlines risk stratification and management strategies for BPF, with the intent to furnish novel insights and methodologies for the clinical diagnosis and treatment of this complex condition.
支气管胸膜瘘（BPF）是肺叶切除术后最严重的并发症之一。目前的治疗策略包括多种手术技术，并辅以必要的辅助治疗。尽管有多种治疗方式，但与BPF相关的死亡率仍然高得令人不安。支气管镜技术的进步导致支气管镜介入治疗被广泛采用，其以安全性高、微创性和有效性而闻名。BPF管理的基石包括使用密封剂、金属覆膜支架和封堵装置，这些封堵的成功与否关键取决于瘘管的尺寸。特别是对于被认为不适合手术干预的扩张性BPF，金属覆膜支架和封堵装置经常受到青睐。本综述通过对现有文献的全面分析，批判性地评估了金属覆膜支架和封堵装置的治疗效果及临床实用性。此外，它还概述了BPF的风险分层和管理策略，旨在为这种复杂病症的临床诊断和治疗提供新的见解和方法。
