支气管镜下骨栓在术后支气管胸膜瘘管理中的应用
Bone Plug in the Bronchoscopic Management of Postoperative Bronchopleural Fistulas.
作者信息
Duong Duy Kevin, Debiane Labib Gilles, Cohen Avi, Peralta A Rolando, Diaz-Mendoza Javier, Simoff Michael J
机构信息
Department of Interventional Pulmonology, Inova Fairfax Hospital, Falls Church, Virginia.
Division of Pulmonary and Critical Care, Henry Ford Hospital, Detroit, Michigan.
出版信息
Ann Thorac Surg Short Rep. 2024 Apr 2;2(3):427-431. doi: 10.1016/j.atssr.2024.03.004. eCollection 2024 Sep.
BACKGROUND
Bronchopleural fistula (BPF) is a rare and often difficult postoperative complication to manage. This case series describes a bronchoscopic technique using a bone plug for closure of BPFs.
METHODS
Six patients at Henry Ford Hospital from 2014 to 2021, who had a postoperative BPF after lung resection with curative intent for non-small cell lung cancer, underwent bronchoscopic placement of a customized bone plug.
RESULTS
All 6 patients experienced initial resolution of the BPF after bone plug placement. Four of the 6 (66.7%) patients were inpatients, with severe pleural space infections requiring chest tube drainage; all patients clinically improved with resolution of persistent air leaks resulting in chest tube removal. Two of the 6 (33.3%) patients had BPF recurrence within 2 months, and 2 of the /6 (33.3%) patients also eventually required additional surgical repair.
CONCLUSIONS
Endobronchial placement of a customized bone plug is an option for the management of postoperative BPF.
背景
支气管胸膜瘘（BPF）是一种罕见且术后管理通常较为困难的并发症。本病例系列描述了一种使用骨栓封堵BPF的支气管镜技术。
方法
2014年至2021年期间，亨利·福特医院的6例患者在接受以治愈为目的的非小细胞肺癌肺切除术后发生了术后BPF，接受了支气管镜下定制骨栓置入术。
结果
所有6例患者在置入骨栓后BPF均初步得到解决。6例患者中有4例（66.7%）为住院患者，伴有严重的胸腔感染需要胸腔闭式引流；所有患者的持续漏气症状均得到临床改善，最终拔除了胸腔引流管。6例患者中有两例（33.3%）在2个月内BPF复发，6例患者中的2例（33.3%）最终也需要额外的手术修复。
结论
支气管内置入定制骨栓是术后BPF管理的一种选择。
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