Kesaev Oleg Shamilevich, Giller Dmitry Borisovich, Saenko Sergey Sergeevich, Pahlevani Elham, Severova Lyudmila Petrovna
Department of Phthisiopulmonology and Thoracic Surgery Named after M.I. Perelman I.M. Sechenov First Moscow State Medical University (Sechenov University), Rostov-on-Don, Russia.
Rostov Regional Clinical Center of Phthisiopulmonology, Rostov-on-Don, Russia.
Ann Thorac Med. 2025 Jan-Mar;20(1):78-81. doi: 10.4103/atm.atm_93_24. Epub 2025 Jan 11.
A 39-year-old female has postoperative empyema with bronchial stump fistula (BSF) after pneumonectomy due to ineffective tuberculosis chemotherapy. Transpleural reamputation of the right main bronchial stump with simultaneous 8-rib thoracoplasty, 6 attempts at endobronchial valve implantation and thoracostomy have failed to cure BSF and empyema. Consequently, an alternative treatment-transsternal transpericardial wedge-shaped resection of the tracheal bifurcation was performed despite its difficulty and was successful. This clinical case demonstrates the complications of BSF with tuberculosis empyema treatment in spite of there existing many alternative therapies. The need for new more effective treatments is highlighted, as well as safe and less technically difficult interventions which could assist patients with BSF.
一名39岁女性因肺结核化疗无效行肺切除术后发生脓胸并支气管残端瘘（BSF）。经胸膜再次切除右主支气管残端并同时行8肋胸廓成形术、6次尝试植入支气管内瓣膜及胸腔造口术均未能治愈BSF和脓胸。因此，尽管难度较大，仍进行了经胸骨经心包楔形切除气管分叉的替代治疗，且取得成功。该临床病例表明，尽管存在多种替代疗法，但BSF合并结核性脓胸的治疗仍存在并发症。强调了需要新的更有效的治疗方法，以及安全且技术难度较小的干预措施，以帮助患有BSF的患者。
