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Surgical Endoscopy

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01-10-2018

Customized airway stenting for bronchopleural fistula after pulmonary resection by interventional technique: single-center study of 148 consecutive patients

Authors: Xinwei Han, Meipan Yin, Lei Li, Ming Zhu, Kewei Ren, Yu Qi, Xiangnan Li, Gang Wu

Published in: Surgical Endoscopy | Issue 10/2018

Abstract

Background

Bronchopleural fistula after pulmonary resection is a serious complication, with major impact on the quality of life and survival. This study aims to evaluate the efficacy and safety of customized airway stenting in the treatment of bronchopleural fistula.

Methods

A series of airway stents for dedicated bronchopleural fistula occlusion were designed after taking into account the anatomical and pathophysiological features of post-pulmonary resection fistulas and the shortcomings of airway stents currently available. The fistulas were occluded with the bullet head or a special part of the covered airway stent. Successful stenting was defined as immediate cessation of air leak from the residual cavity after stenting. The results were retrospectively analyzed.

Results

Airway occlusion stenting was successful on the first attempt in 143/148 (96.6%) patients with bronchopleural fistulas. In the remaining 5 patients, occlusion was successful only on the second try. At follow-up 30 days after stenting, 141 patients reported relief in symptoms. No choking, laryngeal edema, or airway rupture occurred in any patient during stent insertion or removal; 2 patients developed hemorrhage during stent removal.

Conclusions

Airway occlusion stenting appears to be a feasible and effective technique for treatment of bronchopleural fistula.

Deschamps C, Bernard A, Nichols FC III, Allen MS, Miller DL, Trastek VF, Jenkins GD, Pairolero PC (2001) Empyema and bronchopleural fistula after pulmonary resection: factors affecting incidence. Ann Thorac Surg 72:243–248CrossRef

Pforr A, Pagès PB, Baste JM, Thomas P, Falcoz PE, Lepimpec Barthes F, Dahan M, Bernard A, Epithor Project French Society of Thoracic and Cardiovascular Surgery (2016) A predictive score for bronchopleural fistula established using the french database epithor. Ann Thorac Surg 101:287–293CrossRef

Mazzella A, Olland A, Garelli E, Renaud S, Reeb J, Santelmo N, Falcoz PE, Massard G (2017) Video-assisted thoracoscopic surgery is a safe option for benign lung diseases requiring lobectomy. Surg Endosc 31(3):1250–1256CrossRef

Okami J, Tokunaga T, Kanou T, Kunou H, Ishida D, Fujiwara A, Ito Y, Higashiyama M (2017) Randomized study comparing equal height staples with graduated height staples in bronchial closure. Ann Thorac Surg 104(3):1012–1019CrossRef

Kutlu CA, Patlakoglu S, Tasci AE, Kapicibasi O (2009) A novel technique for bronchopleural fistula closure: an hour glass-shaped stent. J Thorac Cardiovasc Surg 137:e46–e47CrossRef

Klotz LV, Gesierich W, Schott-Hildebrand S, Hatz RA, Lindner M (2015) Endobronchial closure of bronchopleural fistula using Amplatzer device. J Thorac Dis 7:1478–1482PubMedPubMedCentral

Podgaetz E, Andrade RS, Zamora F, Gibson H, Dincer HE (2015) Endobronchial treatment of bronchopleural fistulas by using intrabronchial valve system: a case series. Semin Thorac Cardiovasc Surg 27:218–222CrossRef

Chae EY, Shin JH, Song HY, Kim JH, Shim TS, Kim DK (2010) Bronchopleural fistula treated with a silicone-covered bronchial occlusion stent. Ann Thorac Surg 89:293–296CrossRef

Andreetti C, D’Andrilli A, Ibrahim M, Ciccone AM, Maurizi G, Mattia A, Venuta F, Rendina EA (2012) Effective treatment of post-pneumonectomy bronchopleural fistula by conical fully covered self-expandable stent. Interact Cardiovasc Thorac Surg 14:420–423CrossRef

10.

Akulian J, Pathak V, Lessne M, Hong K, Feller-Kopman D, Lee H, Yarmus L (2014) A novel approach to endobronchial closure of a bronchial pleural fistula. Ann Thorac Surg 98:697–699CrossRef

11.

York JA (2013) Treating bronchopleural fistulae percutaneously with N-butyl cyanoacrylate glue. J Vasc Interv Radiol 24:1581–1583CrossRef

12.

State Intellectual Property Office, China, Patent No. ZL03235769.9, ZL03235771.0, ZL200620030663.9, ZL20112000 5812.7, and ZL201120005784.9

13.

Li YD, Han XW, Li MH, Wu G (2006) Bronchial stump fistula: treatment with covered, retrievable, expandable, hinged stents-preliminary clinical experience. Acta Radiol 47:922–926CrossRef

14.

Han X, Wu G, Li Y, Li M (2006) A novel approach: treatment of bronchial stump fistula with a plugged, bullet-shaped, angled stent. Ann Thorac Surg 81:1867–1871CrossRef

15.

Wu G, Li ZM, Han XW, Wang ZG, Lu HB, Zhu M, Ren KW (2013) Right bronchopleural fistula treated with a novel, Y-shaped, single-plugged, covered, metallic airway stent. Acta Radiol 54:656–660CrossRef

16.

Lois M, Noppen M (2005) Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management. Chest 128:3955–3965CrossRef

17.

Jones NC, Kirk AJ, Edwards RD. Edwards (2006) Bronchopleural fistula treated with a covered wall stent. Ann Thorac Surg 81:364–366CrossRef

18.

Kim KH, Lee KH, Won JY, Lee DY, Paik HC, Lee DY (2006) Bronchopleural fistula treatment with use of a bronchial stent-graft ocluder. J Vasc Interv Radiol 17:1539–1543CrossRef

19.

Madden BP, Loke TK, Sheth AC (2006) Do expandable metallic airway stents have a role in the management of patients with benign tracheobronchial disease. Ann Thorac Surg 82:274–278CrossRef

20.

Ferraroli GM, Testori A, Cioffi U, De Simone M, Alloisio M, Galliera M, Ciulla MM, Ravasi G (2006) Healing of bronchopleural fistula using a modified Dumon stent: a case report. J Cardiothorac Surg 1:16CrossRef

21.

Bellato V, Ferraroli GM, De Caria D, Infante MV, Cariboni U, Spoto MR, Alloisio M, Bordone G (2010) Management of postoperative bronchopleural fistula with a tracheobronchial stentin a patient requiring mechanical ventilation. Intensive Care Med 36:721–722CrossRef

22.

Koh MS, Ling Hsu AA, Thirugnanam A (2005) Novel management of a large chronic bronchocutaneous fistula after lobectomy. Interact CardioVasc Thorac Surg 4:248–249CrossRef

23.

Madden BP, Sheth A, Ho TB, McAnulty GR, Sayer RE (2005) A novel approach to the management of persistent postpneumonectomy bronchopleural fistula. Ann Thorac Surg 79:2128–2130CrossRef

Title: Customized airway stenting for bronchopleural fistula after pulmonary resection by interventional technique: single-center study of 148 consecutive patients
Authors: Xinwei Han
Meipan Yin
Lei Li
Ming Zhu
Kewei Ren
Yu Qi
Xiangnan Li
Gang Wu
Publication date: 01-10-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6152-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Customized airway stenting for bronchopleural fistula after pulmonary resection by interventional technique: single-center study of 148 consecutive patients

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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