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既往缝合类型及瘘管直径可预测肺切除术后支气管胸膜瘘的整体修复成功率。

Previous Suture Type and Diameter of Fistula Predict Overall Repair Success for Post-Pneumonectomy Bronchopleural Fistulas.

作者信息

Akyıl Mustafa, Baysungur Volkan

机构信息

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Ann Thorac Cardiovasc Surg. 2025;31(1). doi: 10.5761/atcs.oa.25-00029.

Abstract

PURPOSE

This study aims to evaluate the treatment outcomes for patients who developed post-pneumonectomy bronchopleural fistula (BPF) and to identify factors that may influence the success of these treatment methods.

METHODS

A cohort of 60 patients diagnosed with resistant BPF following pneumonectomy for non-small cell lung cancer was included in the study. Patients were categorized into 2 groups based on the efficacy of the BPF closure methods: successful closure and failed closure. Data on demographic, clinical, and pathological characteristics, surgical procedures, oncologic treatment status, laboratory parameters at the time of BPF diagnosis, fistula diameter, and bronchial stump length were collected. The effectiveness of bronchoscopic treatments and advanced surgical procedures was analyzed.

RESULTS

Of the 60 patients included in the study, 55 (95%) were male, with a mean age of 61.6 ± 9.4 years. Multivariate analysis identified fistula diameter and the type of previous suture as significant predictors of BPF closure success ( p = 0.024 and 0.008, respectively).

CONCLUSION

Fistula diameter and previous suture type are critical determinants of the success of post-pneumonectomy BPF closure.

摘要

目的

本研究旨在评估肺切除术后支气管胸膜瘘(BPF)患者的治疗效果,并确定可能影响这些治疗方法成功的因素。

方法

本研究纳入了一组60例因非小细胞肺癌行肺切除术后诊断为难治性BPF的患者。根据BPF闭合方法的疗效将患者分为两组:成功闭合组和失败闭合组。收集了患者的人口统计学、临床和病理特征、手术过程、肿瘤治疗状况、BPF诊断时的实验室参数、瘘管直径和支气管残端长度等数据。分析了支气管镜治疗和先进手术方法的有效性。

结果

本研究纳入的60例患者中,55例(95%)为男性,平均年龄为61.6±9.4岁。多因素分析确定瘘管直径和既往缝合类型是BPF闭合成功的重要预测因素(分别为p = 0.024和0.008)。

结论

瘘管直径和既往缝合类型是肺切除术后BPF闭合成功的关键决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0642/12256148/95334426fd6e/atcs-31-1-25-00029-figure01.jpg

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