Abstract
Background/aimThe 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.MethodsThis 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.ResultsOut 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.ConclusionThe 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.
Highlights
Lung resection remains the treatment of choice for bronchogenic carcinoma and intractable end-stage localized lung disease such as tuberculosis, bronchiectasis, lung abscess and hydatidosis
Post-lobectomy bronchopleural fistula (BPF) occurred in eight patients (1.7%), while post-pneumonectomy BPF happened in ten (11.1%) patients (Fig. 1)
BPF was observed in 3.7% of the patients operated for lung cancer and only in 1.6% of the patients operated for other lung pathologies
Summary
Our study included 558 patients, among whom, 14.4% were females and 85.6% males. Average age was 62.4 years (±12SD). Male Female Mean age Diagnosis Lung cancer Lung Echinoccocus Bronchiectasis, Lung abscess, Tuberculosis Type of intervent Lobectomy Pneumonectomy Complications No Yes. Post-lobectomy BPF did not occur in any of the patients who had the FRBS procedure compared to 2.3% among patients who did not have the FRBS, the differences were not statistically significant (p > 0.05; Fisher’s exact test). We found a higher rate of BPF among patients with cardiovascular and other pulmonary diseases compared to those with other concomitant illnesses, but this result was not statistically significant (Chi-square test) (Table 5).
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
