БРОНХИАЛЬНЫЙ СВИЩ – ГРОЗНОЕ И КОВАРНОЕ ОСЛОЖНЕНИЕ В ОНКОЛОГИЧЕСКОЙ ПРАКТИКЕ

Abstract

Bronchopleural fistula is one of the most dangerous complications in thoracic surgery and can occur both in the early postoperative period (especially in the first 7-10 days after surgical treatment) and many years after surgery. In most cases, the appearance of a bronchial fistula is associated with the progression of the oncological process, post-radiation changes in the bronchus stump, and also with a persistent pulmonary infection. The incidence of bronchus suture failure after pneumonectomy for non-small cell lung cancer is 1.5-12.5%, after lobectomy – 1-4%. Among the predictors of the development of this complication, there are: male sex, age over 65 years, patients with severe (ASA 3 or higher) and numerous concomitant diseases, right-sided and extended operations, combined antitumor treatment. A special role in the prevention of the development of bronchopleural fistula is given to surgical techniques for covering the bronchus stump with various tissues, mainly the pleura or muscles. The treatment of bronchial fistula involves the relief of the general inflammatory reaction, the sanitation of the residual pleural cavity and the direct closure of the defect, using various options for broncho- and thoracoplasty.