Van Schil P E, Van Meerbeeck J P
Dept of Surgery, University Hospital of Antwerp, Edegem, Belgium.
Monaldi Arch Chest Dis. 1996 Oct;51(5):421-3.
Bronchopleural fistula (BPF) is a dramatic complication after lung resection. Its incidence ranges 1-4% and most cases occur after right pneumonectomy. A careful surgical technique of bronchial closure is necessary to avoid this complication. Occult bronchopleural fistulas can be treated conservatively, unless there are signs of infection. Immediate drainage of the postpneumonectomy space is mandatory for a bronchopleural fistula which becomes clinically evident. Very small fistulas can be closed by the application of fibrin glue. For an early postpneumonectomy fistula, reoperation is necessary, with redivision and suturing of the bronchial stump. The bronchial suture line should be covered by omentum, pericardial fat or a muscle flap to provide viable tissue. Even with current techniques, morbidity and mortality of this serious complication remain high.
支气管胸膜瘘（BPF）是肺切除术后一种严重的并发症。其发生率为1% - 4%，大多数病例发生在右肺切除术后。为避免出现这种并发症，细致的支气管闭合手术技术很有必要。隐匿性支气管胸膜瘘可采用保守治疗，除非出现感染迹象。对于临床上已明确的支气管胸膜瘘，必须立即引流肺切除术后的胸腔。极小的瘘口可通过应用纤维蛋白胶来闭合。对于早期肺切除术后瘘，需要再次手术，重新分离并缝合支气管残端。支气管缝合线应由网膜、心包脂肪或肌瓣覆盖，以提供有活力的组织。即便采用当前技术，这种严重并发症的发病率和死亡率仍然很高。
