Soner Gursoy1, Serkan Yazgan2, Ahmet Ucvet1, Ozgur Samancilar1, Mehmet Unal1, Baris Gulmez1, Esra Yamansavci Sirzai1. 1. Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Medical Practice and Research Center, University of Health Sciences, Yenisehir-Konak, Izmir, Turkey. 2. Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Medical Practice and Research Center, University of Health Sciences, Yenisehir-Konak, Izmir, Turkey. serkanyazgan@gmail.com.
Abstract
PURPOSE: Bronchopleural fistula (BPF) is a catastrophic complication after pneumonectomy, still associated with high mortality. We reviewed our recent experience of managing BPF, particularly after right pneumonectomy for non-small cell lung cancer (NSCLC), and analyzed our findings. METHODS: A total of 436 patients underwent pneumonectomy for NSCLC in our department between January 2000 and June 2017. BPF developed during follow-up in 47 of these patients, who are the subjects of this retrospective analysis. RESULTS: The overall incidence of BPF was 10.8% (47/436), being 22.8% (33/145) after right pneumonectomy and 4.8% (14/291) after left pneumonectomy (P = 0.0001). The incidence of BPF in patients with a history of tuberculosis was 33.3% (6/18; P = 0.008). The fistula healed in 48.9% (23/47) of the patients and the rate of mortality caused by the fistula was 19.1% (9/47). CONCLUSIONS: The side of the pneumonectomy and previous tuberculosis were the two most important risk factors independent of the bronchial closure methods. The incidence of BPF was much higher after right pneumonectomy than after left pneumonectomy. The high mortality and morbidity rates show that the treatment of BPF is still not satisfactory.
PURPOSE:Bronchopleural fistula (BPF) is a catastrophic complication after pneumonectomy, still associated with high mortality. We reviewed our recent experience of managing BPF, particularly after right pneumonectomy for non-small cell lung cancer (NSCLC), and analyzed our findings. METHODS: A total of 436 patients underwent pneumonectomy for NSCLC in our department between January 2000 and June 2017. BPF developed during follow-up in 47 of these patients, who are the subjects of this retrospective analysis. RESULTS: The overall incidence of BPF was 10.8% (47/436), being 22.8% (33/145) after right pneumonectomy and 4.8% (14/291) after left pneumonectomy (P = 0.0001). The incidence of BPF in patients with a history of tuberculosis was 33.3% (6/18; P = 0.008). The fistula healed in 48.9% (23/47) of the patients and the rate of mortality caused by the fistula was 19.1% (9/47). CONCLUSIONS: The side of the pneumonectomy and previous tuberculosis were the two most important risk factors independent of the bronchial closure methods. The incidence of BPF was much higher after right pneumonectomy than after left pneumonectomy. The high mortality and morbidity rates show that the treatment of BPF is still not satisfactory.
Entities:
Keywords:
Bronchopleural fistula; Lung cancer; Pneumonectomy; Right pneumonectomy; Tuberculosis
Authors: Gail E Darling; Adel Abdurahman; Qi-Long Yi; Michael Johnston; Thomas K Waddell; Andrew Pierre; Shaf Keshavjee; Robert Ginsberg Journal: Ann Thorac Surg Date: 2005-02 Impact factor: 4.330
Authors: A Bernard; C Deschamps; M S Allen; D L Miller; V F Trastek; G D Jenkins; P C Pairolero Journal: J Thorac Cardiovasc Surg Date: 2001-06 Impact factor: 5.209