Fatmir Caushi1,2, Gentiana Qirjako3, Ilir Skenduli4, Daniela Xhemalaj4, Hasan Hafizi4, Silva Bala4, Alban Hatibi4, Arian Mezini4. 1. Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Tirana, Albania. fcaushi@yahoo.com. 2. Department of Surgery, Our Lady of Good Counsel University, Tirana, Albania. fcaushi@yahoo.com. 3. Department of Public Health, University of Medicine, Tirana, Albania. 4. Department of Thoracic Surgery, University Hospital "Shefqet Ndroqi", Tirana, Albania.
Abstract
BACKGROUND/AIM: The development of bronchopleural fistula (BPF) remains the most severe complication of lung resection, especially after pneumonectomy. Studies provide controversial reports regarding the benefits of flap reinforcement of the bronchial stump (FRBS) in preventing BPF's occurrence. METHODS: This is a retrospective cohort study of 558 patients that underwent lung resection in a 12-year period (from 2007 to 2018). Ninety patients (16.1%) underwent pneumonectomy. Patient follow-up period varied from 1 to 12 years. RESULTS: Out of 558 patients in this study, 468 (83.9%) underwent lobectomy, and the remnant underwent pneumonectomy. In 114 cases with lobectomy, only 24.4% had FRBS, meanwhile in 56 cases with pneumonectomy only 62.2% had FRBS. BPF occurred in 8 patients with lobectomy (1.7%) and in 10 patients with pneumonectomy (11.1%). Among cases with post-pneumonectomy BPF, 6 (10.7%) had FRBS performed, while no FRBS was performed among patients with post-lobectomy BPF, although these data weren't statistically (p > 0.05). In 24 patients (20 lobectomies and 4 pneumonectomies) with lung cancer (10.4%) neoadjuvant treatment was performed, in which 20 patients underwent chemotherapy and 4 underwent radiotherapy. FRBS was applied in each of the above 24 operative cases, but only in 4 of them the BPF was verified. CONCLUSION: The idea of enhancing the blood supply through the FRBS for BPF prevention has gain traction. Although FRBS has been identified as valuable and effective method in BPF prevention following lung resection, our study results did not support this evidence.
BACKGROUND/AIM: The development of bronchopleural fistula (BPF) remains the most severe complication of lung resection, especially after pneumonectomy. Studies provide controversial reports regarding the benefits of flap reinforcement of the bronchial stump (FRBS) in preventing BPF's occurrence. METHODS: This is a retrospective cohort study of 558 patients that underwent lung resection in a 12-year period (from 2007 to 2018). Ninety patients (16.1%) underwent pneumonectomy. Patient follow-up period varied from 1 to 12 years. RESULTS: Out of 558 patients in this study, 468 (83.9%) underwent lobectomy, and the remnant underwent pneumonectomy. In 114 cases with lobectomy, only 24.4% had FRBS, meanwhile in 56 cases with pneumonectomy only 62.2% had FRBS. BPF occurred in 8 patients with lobectomy (1.7%) and in 10 patients with pneumonectomy (11.1%). Among cases with post-pneumonectomy BPF, 6 (10.7%) had FRBS performed, while no FRBS was performed among patients with post-lobectomy BPF, although these data weren't statistically (p > 0.05). In 24 patients (20 lobectomies and 4 pneumonectomies) with lung cancer (10.4%) neoadjuvant treatment was performed, in which 20 patients underwent chemotherapy and 4 underwent radiotherapy. FRBS was applied in each of the above 24 operative cases, but only in 4 of them the BPF was verified. CONCLUSION: The idea of enhancing the blood supply through the FRBS for BPF prevention has gain traction. Although FRBS has been identified as valuable and effective method in BPF prevention following lung resection, our study results did not support this evidence.
Authors: C Deschamps; A Bernard; F C Nichols; M S Allen; D L Miller; V F Trastek; G D Jenkins; P C Pairolero Journal: Ann Thorac Surg Date: 2001-07 Impact factor: 4.330
Authors: W Klepetko; S Taghavi; A Pereszlenyi; T Bîrsan; J Groetzner; N Kupilik; O Artemiou; E Wolner Journal: Eur J Cardiothorac Surg Date: 1999-06 Impact factor: 4.191
Authors: Shahrokh Taghavi; Gabriel M Marta; Georg Lang; Gernot Seebacher; Gunther Winkler; Katharina Schmid; Walter Klepetko Journal: Ann Thorac Surg Date: 2005-01 Impact factor: 4.330
Authors: Panagiotis G Sfyridis; Emmanouil I Kapetanakis; Nikolaos E Baltayiannis; Nikolaos V Bolanos; Dimitrios S Anagnostopoulos; Antonios Markogiannakis; Antonios Chatzimichalis Journal: Ann Thorac Surg Date: 2007-09 Impact factor: 4.330
Authors: Antonio D'Andrilli; Mohsen Ibrahim; Claudio Andreetti; Anna Maria Ciccone; Federico Venuta; Erino A Rendina Journal: Ann Thorac Surg Date: 2009-07 Impact factor: 4.330