Bronchoscopic management of bronchopleural fistula

Yıl 2016, Cilt: 1 Sayı: 1, 38 - 43, 29.12.2016

Davor Stamenovic

Öz

Bronchopleural fistula (BPF) represents a pathological communication between any part of bronchial tree and the pleural space. Mostly it is a rare yet serious complication of different pulmonary conditions like certain infections, trauma, malignancy and/or surgery, going along with significant mortality reported to be as high as 58%. Diagnosis of BPF is mostly done by evaluating these three data: clinical appearance, bronchoscopy and CT scan. The treatment of BPF may initially differ according to the time of appearance as well as clinical presentation. As most BPF goes along with empyema, it is, obviously, necessary to deal with it. This is most commonly achieved with a chest tube. Conservative management of BPF can be achieved using a significant variety of materials and methods with reportedly moderate to excellent results in the treatment of etiologically and sizably different BPF. Methyl-2-cyanoacrylate, fibrin sealant together with spongy calf bone, polidocanol - hydroxypolyethoxidodecane, amplatzer device, silver nitrate, stenting and endobronchial valves have all been employed in bronchoscopic treatment of a BPF. There is no evidence based guideline for its management, either surgically or endoscopically. The treatment of choice is always in the hands of the physician, preferably armed with the current knowledge and capacity of utilizing it.

Anahtar Kelimeler

Bronchopleural fistula, bronchial fistula, bronchoscopy, pleural disease, empyema, surgery

Kaynakça

• Uramoto H, Hanagiri T. The development of bronchopleural fistula in lung cancer patients after major surgery: 31 years of experience with 19 cases. Anticancer Res 2011; 31: 619-24.
• Lois M, Noppen M. Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management. Chest 2005;128:3955-65.
• Sirbu H, Busch T, Aleksic I, Schreiner W, Oster O, Dalichau H. Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management. Ann Thorac Cardiovasc Surg 2001; 7: 330-6.
• Cerfolio RJ. The incidence, etiology, and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg 2001; 13: 3-7.
• al-Kattan K, Cattelani L, Goldstraw P. Bronchopleural fistula after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 1995; 9: 479-82.
• Boudaya MS, Smadhi H, Zribi H, Mohamed J, Ammar J, Mestiri T, et al. Conservative management of postoperative bronchopleural fistulas. J Thorac Cardiovasc Surg 2013; 146: 575-9.
• Ratliff JL, Hill JD, Tucker H, Fallat R. Endobronchial control of bronchopleural fistulae. Chest 1977; 71: 98-9.
• Hartmann W, Rausch V. New therapeutic application of the fiberoptic bronchoscope. Chest 1977; 71: 237.
• Scappaticci E, Ardissone F, Ruffini E, et al. Postoperative bronchopleural fistula: endoscopic closure in 12 patients. Ann Thorac Surg 1994; 57: 119-22.
• Roksvaag H, Skalleberg L, Nordberg C, Solheim K, Hoivik B. Endoscopic closure of bronchial fistula. Thorax 1983;38: 696-7.
• Torre M, Chiesa G, Ravini M, Vercelloni M, Belloni PA. Endoscopic gluing of bronchopleural fistula. The Ann Thorac Surg 1987; 43:295-97.
• Wood RE, Lacey SR, Azizkhan RG. Endoscopic management of large, postresection bronchopleural fistulae with methacrylate adhesive (Super Glue). J Pediatr Surg 1992; 27: 201-2.
• Hollaus PH, Lax F, Janakiev D, Lucciarini P, Katz E, Kreuzer A, et al. Endoscopic treatment of postoperative bronchopleural fistula: experience with 45 cases. Ann Thorac Surg 1998; 66: 923-7.
• Varoli F, Roviaro G, Grignani F, Vergani C, Maciocco M, Rebuffat C. Endoscopic treatment of bronchopleural fistulas. Ann Thorac Surg 1998; 65: 807-9.
• Kramer MR, Peled N, Shitrit D, Atar E, Saute M, Shlomi D, et al. Use of Amplatzer device for endobronchial closure of bronchopleural fistulas. Chest 2008; 133: 1481-4.
• Fruchter O, Kramer MR, Dagan T, Raviv Y, Abdel-Rahman N, Saute M, et al. Endobronchial closure of bronchopleural fistulae using amplatzer devices: our experience and literature review. Chest 2011; 139: 682-7.
• Fruchter O, Bruckheimer E, Raviv Y, Rosengarten D, Saute M, Kramer MR. Endobronchial closure of bronchopleural fistulas with Amplatzer vascular plug. Eur J Cardiothorac Surg 2012; 41: 46-9.
• Scordamaglio PR, Tedde ML, Minamoto H, Pedra CA, Jatene FB. Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results. J Bras Pneumol 2009; 35: 1156-60.
• Gulkarov I, Paul S, Altorki NK, Lee PC. Use of Amplatzer device for endobronchial closure of bronchopleural fistulas. Interact Cardiovasc Thorac Surg 2009; 9: 901-2.
• Klotz LV, Gesierich W, Schott-Hildebrand S, Hatz RA, Lindner M. Endobronchial closure of bronchopleural fistula using Amplatzer device. J Thorac Dis 2015; 7: 1478-82.
• Watanabe S, Shimokawa S, Yotsumoto G, Sakasegawa K. The use of a Dumon stent for the treatment of a bronchopleural fistula. Ann Thorac Surg 2001; 72: 276-8.
• Koh MS, Ling Hsu AA, Thirugnanam A. Novel management of a large chronic bronchocutaneous fistula after lobectomy. Interact Cardiovasc Thorac Surg 2005; 4: 248-9.
• Dutau H, Breen DP, Gomez C, Thomas PA, Vergnon JM. The integrated place of tracheobronchial stents in the multidisciplinary management of large post-pneumonectomy fistulas: our experience using a novel customised conical self-expandable metallic stent. Eur J Cardiothorac Surg 2011; 39: 185-9.
• Andreetti C, D'Andrilli A, Ibrahim M, Ciccone AM, Maurizi G, Mattia A, et al. Effective treatment of post-pneumonectomy bronchopleural fistula by conical fully covered self-expandable stent. Interact Cardiovasc Thorac Surg 2012; 14: 420-3.
• Snell GI, Holsworth L, Fowler S, Ericksson L, Reed A, Daniels FJ, et al. Occlusion of a broncho-cutaneous fistula with endobronchial one-way valves. Ann Thorac Surg 2005; 80: 1930-2.
• Toma TP, Kon OM, Oldfield W, Sanefuji R, Griffiths M, Wells F, et al. Reduction of persistent air leak with endoscopic valve implants. Thorax 2007; 62: 830-3.
• Schweigert M, Kraus D, Ficker JH, Stein HJ. Closure of persisting air leaks in patients with severe pleural empyema--use of endoscopic one-way endobronchial valve. Eur J Cardiothorac Surg 2011; 39: 401-3.
• Reed MF, Gilbert CR, Taylor MD, Toth JW. Endobronchial valves for challenging air leaks. Ann Thorac Surg 2015; 100: 1181-6.
• Hance JM, Martin JT, Mullett TW. Endobronchial valves in the treatment of persistent air leaks. Ann Thorac Surg 2015; 100: 1780-5; discussion 85-6.