| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 1996;112:1367-1371
© 1996 Mosby, Inc.
GENERAL THORACIC SURGERY |
From the General Thoracic Surgical Unit, Massachusetts General Hospital, Boston, Mass.
Received for publication May 6, 1996 Revisions requested May 24, 1996; revisions received June 5, 1996 Accepted for publication June 7, 1996. Address for reprints: Cameron D. Wright, MD, Thoracic Surgery, Warren 1212, Massachusetts General Hospital, Boston, MA 02114.
Abstract
Objective: Postpneumonectomy bronchopleural fistula remains a morbid complication after pneumonectomy. The incidence, risk factors, and management of postpneumonectomy bronchopleural fistula were evaluated in 256 consecutive patients who underwent pneumonectomy with a standardized suture closure of the bronchus.
Methods: Pneumonectomy was performed for lung cancer in 198 cases, for other malignancy in 20 cases, and for benign causes in 38 cases. The bronchial stump was closed with interrupted simple sutures to emphasize a long, membranous wall flap. All stumps were covered by autologous tissue.
Results: The incidence of postpneumonectomy bronchopleural fistula was 3.1%. Risk factors for bronchopleural fistula were the need for postoperative ventilation (p = 0.0001) and right pneumonectomy (p = 0.04). Five patients had bronchopleural fistulas as a result of pulmonary complications necessitating ventilation; the cause in the remaining three cases appeared to be technical. Reclosure was successful in five cases (mean postoperative day 12); in one case a pinhole fistula was healed by drainage alone. Two (25%) of the eight patients who had bronchopleural fistulas died.
Conclusions: Careful, sutured closure of the main bronchus with a tissue buttress after pneumonectomy yields excellent results. The most significant risk factor for bronchopleural fistula is a pulmonary complication necessitating ventilation. Contrary to previous reports, reclosure is usually successful even if performed late. (J THORACCARDIOVASCSURG1996;112:1367-71)
This article has been cited by other articles:
|
|
 |
|
  Q.V. Jichen, G. Chen, G. Jiang, J. Ding, W. Gao, and C. Chen Risk factor comparison and clinical analysis of early and late bronchopleural fistula after non-small cell lung cancer surgery. Ann. Thorac. Surg., November 1, 2009; 88(5): 1589 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. D. Panagopoulos, E. Apostolakis, E. Koletsis, C. Prokakis, P. Hountis, G. Sakellaropoulos, I. Bellenis, and D. Dougenis Low incidence of bronchopleural fistula after pneumonectomy for lung cancer Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 571 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Gursoy, M. U Yapucu, A. Ucvet, S. Yazgan, O. Basok, and S. Ermete Fibrin Glue Administration to Support Bronchial Stump Line Asian Cardiovasc Thorac Ann, December 1, 2008; 16(6): 450 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Schneiter, T. Grodzki, D. Lardinois, P. B. Kestenholz, J. Wojcik, B. Kubisa, J. Pierog, and W. Weder Accelerated treatment of postpneumonectomy empyema: A binational long-term study J. Thorac. Cardiovasc. Surg., July 1, 2008; 136(1): 179 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Kesler, Z. T. Hammoud, K. M. Rieger, L. E. Kruter, M. Yu, and J. W. Brown Carinaplasty Airway Closure: A Technique for Right Pneumonectomy Ann. Thorac. Surg., April 1, 2008; 85(4): 1178 - 1186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Nagahiro, M. Aoe, Y. Sano, H. Date, A. Andou, and N. Shimizu Bronchopleural Fistula After Lobectomy for Lung Cancer Asian Cardiovasc Thorac Ann, February 1, 2007; 15(1): 45 - 48. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Maniwa, Y. Saito, H. Kaneda, and H. Imamura Bronchial stump reinforcement with the intercostal muscle flap without adverse effects. Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 652 - 656. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ganti, R. Milton, V. Anikin, and A. Thorpe Surgery for tumour recurrence in a pneumonectomy space. Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 683 - 685. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. Chae, J. B. Seo, S. Y. Kim, K.-H. Do, J.-N. Heo, J. S. Lee, K. S. Song, J. W. Song, and T.-H. Lim Radiographic and CT Findings of Thoracic Complications after Pneumonectomy RadioGraphics, September 1, 2006; 26(5): 1449 - 1468. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Chichevatov, A. Gorshenev, and E. Sinev Preventive diaphragm plasty after pneumonectomy on account of lung cancer. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): 265 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Tao, M. Araki, T. Sato, S. Morino, R. Kawanami, M. Yoshitani, and T. Nakamura Bronchoscopic treatment of postpneumonectomy bronchopleural fistula with a collagen screw plug J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 99 - 104. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Sherwood, J. D. Mitchell, and M. Pomerantz Completion pneumonectomy for chronic mycobacterial disease J. Thorac. Cardiovasc. Surg., June 1, 2005; 129(6): 1258 - 1265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ludwig, U. Hoffarth, J. Haberstroh, W. Schuttler, B. Passlick, and E. Stoelben Resistance to pressure of the stump after mechanical stapling or manual suture. An experimental study on sheep main bronchus Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 693 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Taghavi, G. M. Marta, G. Lang, G. Seebacher, G. Winkler, K. Schmid, and W. Klepetko Bronchial Stump Coverage With a Pedicled Pericardial Flap: An Effective Method for Prevention of Postpneumonectomy Bronchopleural Fistula Ann. Thorac. Surg., January 1, 2005; 79(1): 284 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Shiraishi, Y. Nakajima, N. Katsuragi, M. Kurai, and N. Takahashi Pneumonectomy for nontuberculous mycobacterial infections Ann. Thorac. Surg., August 1, 2004; 78(2): 399 - 403. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Lin and M. D. Iannettoni Closure of bronchopleural fistulas using Albumin-Glutaraldehyde tissue adhesive Ann. Thorac. Surg., January 1, 2004; 77(1): 326 - 328. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bazzocchi, A. Bini, M. Grazia, and F. Petrella Bronchopleural fistula prevention after major pulmonary resection for primary lung cancer Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 160 - 160. [Full Text] [PDF]
|
|
|
|
|
|
A.E. Martin-Ucar, N. Chaudhuri, J.G. Edwards, and D.A. Waller Can pneumonectomy for non-small cell lung cancer be avoided? An audit of parenchymal sparing lung surgery Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 601 - 605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.P. van Meerbeeck, R.A.M. Damhuis, and M.L. Vos de Wael High postoperative risk after pneumonectomy in elderly patients with right-sided lung cancer Eur. Respir. J., January 1, 2002; 19(1): 141 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Kim, K. S. Lee, Y. M. Shim, J. Kim, K. Kim, T. S. Kim, and P. S. Yang Radiographic and CT Findings in Complications Following Pulmonary Resection RadioGraphics, January 1, 2002; 22(1): 67 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. J. Algar, A. Alvarez, J. L. Aranda, A. Salvatierra, C. Baamonde, and F. J. Lopez-Pujol Prediction of early bronchopleural fistula after pneumonectomy: a multivariate analysis Ann. Thorac. Surg., November 1, 2001; 72(5): 1662 - 1667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Schneiter, P. Cassina, S. Korom, I. Inci, M. Al-Abdullatief, A. Dutly, P. Kestenholz, and W. Weder Accelerated treatment for early and late postpneumonectomy empyema Ann. Thorac. Surg., November 1, 2001; 72(5): 1668 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Deschamps, A. Bernard, F. C. Nichols III, M. S. Allen, D. L. Miller, V. F. Trastek, G. D. Jenkins, and P. C. Pairolero Empyema and bronchopleural fistula after pneumonectomy: factors affecting incidence Ann. Thorac. Surg., July 1, 2001; 72(1): 243 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Stephan, S. Boucheseiche, J. Hollande, A. Flahault, A. Cheffi, B. Bazelly, and F. Bonnet Pulmonary Complications Following Lung Resection : A Comprehensive Analysis of Incidence and Possible Risk Factors Chest, November 1, 2000; 118(5): 1263 - 1270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Fahimi, F. Casselman, M. A. Mariani, W. Jan van Boven, and H. van Swieten Wedge carinal resection for closure of the main bronchus after pneumonectomy Ann. Thorac. Surg., September 1, 2000; 70(3): 987 - 989. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. de Perrot and A. Spiliopoulos Postpneumonectomy bronchopleural fistula Ann. Thorac. Surg., November 1, 1999; 68(5): 1886 - 1887. [Full Text] [PDF]
|
|
|
|
|
|
J.-J. Hubaut, O. Baron, O. Al Habash, Ph. Despins, D. Duveau, and J.L. Michaud Closure of the bronchial stump by manual suture and incidence of bronchopleural fistula in a series of 209 pneumonectomies for lung cancer Eur. J. Cardiothorac. Surg., October 1, 1999; 16(4): 418 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Massard, R. Kessler, B. Gasser, X. Ducrocq, S. Elia, S. Gouzou, and J.-M. Wihlm Local control of disease and survival following bronchoplastic lobectomy for non-small cell lung cancer Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 276 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Klepetko, S. Taghavi, A. Pereszlenyi, T. Birsan, J. Groetzner, N. Kupilik, O. Artemiou, and E. Wolner Impact of different coverage techniques on incidence of postpneumonectomy stump fistula Eur. J. Cardiothorac. Surg., June 1, 1999; 15(6): 758 - 763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Mitchell, D. J. Mathisen, C. D. Wright, J. C. Wain, D. M. Donahue, A. C. Moncure, and H. C. Grillo CLINICAL EXPERIENCE WITH CARINAL RESECTION J. Thorac. Cardiovasc. Surg., January 1, 1999; 117(1): 39 - 53. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
