Results of surgical closure of bronchopleural fistula with vascularized tissues

Abstract

BackgroundBronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree or lung parenchyma resulting in air leak in the chest tubes. Chronic BPF is a serious complication of several pulmonary and postoperative conditions, as it carries a high morbidity and mortality and is associated with prolonged hospital stay and thus high resource consumption. Till date surgical intervention has been the main stay of management of chronic BPF.This study was carried out to assess the efficacy of surgical closure of the chronic BPF using vascularized tissue transfer into the pleural cavity. Patients and methods28 patients were operated upon primarily due to chronic BPF with or without empyema. All patients were selected and subjected to surgical intervention using vascularized tissue transfer into the pleural cavity. The vascularized tissues had been used were: Intercostal muscle flap, Latissmus dorsi muscle transposition, Omental flap, and Pericardial pad of fat. ResultsThe mean hospital stay postoperatively was 4 ± 1 day. There was immediate or early stoppage of air leak after the intervention in all patients. No patient had prolonged postoperative air leak (≥5 days). One patient required negative suction for 2 days to help stoppage of the leak. No patient required instillation of sealants through the tubes. ConclusionOnce the BPF has developed, early recognition, drainage of the pleural space and control of the inflammatory process are critical. Surgical closure of BPFs with proper vascularized tissues is an effective technique associated with low cost and lower hospital stay.