Endobronchial Naso-bronchial Lavage for Post-lobectomy Bronchopleural Fistula: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANGShu-feng ^1,2 , NINGYe ¹ ,  ZHAOXue-wei ¹

1. Department of Thoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, P. R. China;
2. Department of Surgery, Jinzhai People's Hospital, Jinzhai 237300 Anhui, P. R. China;

Corresponding?author：

ZHAOXue-wei, Email: 285466584@qq.com

Keywords：

Bronchopleural?stula; Lobectomy; Conservative treatment

DOI：

10.7507/1007-4848.20160215

Video：

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Objective To evaluate effect and safety of a novel conservative therapy for post-lobectomy bronchopleural fistula. Methods We retrospectively analyzed the clinical data of 20 patients with post-lobectomy bronchopleural fistula in our hospital between 2000 and 2013 year. There were 12 males and 8 females at average age of 67.7±8.7 years. Endobronchial naso-bronchial lavage (ENBL) was used for 10 patients (an ENBL group). Traditional method-thoracostomy drainage tube (TDT) was used for the other 10 patients (a TDT group). Results Compared with the TDT group, shorter hospital day was found in the ENBL group (49.7±9.6 d versus 68.3±9.8 d, P < 0.001). Fistula healing time was also shorter in the ENBL group than that in the TDT group (43.7±9.7 d versus 62.6±8.8 d, P < 0.001). There were lower complication rate, less inflammatory reaction, and better recovery in the ENBL group than those in the TDT group. Conclusion ENBL may be a promising procedure for post-lobectomy bronchopleural fistula.

Citation： WANGShu-feng, NINGYe, ZHAOXue-wei. Endobronchial Naso-bronchial Lavage for Post-lobectomy Bronchopleural Fistula: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(9): 898-900. doi: 10.7507/1007-4848.20160215 Copy

1.	Wertzel H, Bonnet R, Swoboda L, et al. Chief editor. Postoperative bronchial stump fistula-treatment with fibrin glue and spongy bone graft. Fibrin Sealing in Surgical and Nonsurgical Fields. 1th ed. Berlin Heidelberg:Springer-Verlag, 1995. 194-200.
2.	Shields TW, General features and complications of pulmonary resections. General Thoracic Surgery. 4th ed. Baltimore:Williams and Wilkins, 1994. 407-409.
3.	McManigle JE, Fletcher GL, Tenholder MF. Bronchoscopy in the management of bronchopleural fistula. Chest, 1990, 97(5):1235-1238.
4.	Baumann MH, Sahn SA. Medical management and therapy of bronchopleural fistulas in the mechanically ventilated patient. Chest, 1990, 97(3):721-728.
5.	Nagahiro I, Aoe M, Sano Y, et al. Bronchopleural fistula after lobectomy for lung cancer. Asian Cardiovasc Thorac Ann, 2007, 15(1):45-48.
6.	Sirbu H, Busch T, Aleksic I, et al. Bronchopleural fistula in the surgery of non-small cell lung cancer:incidence, risk factors, and management. Ann Thorac Cardiovasc Surg, 2001, 7(6):330-336.
7.	Cooper WA, Miller JI Jr. Management of bronchopleural fistula after lobectomy. Semin Thorac Cardiovasc Surg, 2001, 13(1):8-12.
8.	Hollaus HP, Law F, El-Nashef BB, et al. Natural history of bronchopleural fistula after pneumonectomy:a review of 96 cases. Ann Thorac Surg, 1997, 63(5):1391-1397.
9.	Sarkar P, Chandak T, Shah R, et al. Diagnosis and management bronchopleural fistula. Indian J Chest Dis Allied Sci, 2010, 52(2):97-104.
10.	Baumann WR, Ulmer JL, Ambrose PG, et al. Closure of a bronchopleural fistula using decalcified human spongiosa and a fibrin sealant. Ann Thorac Surg, 1997, 64(1):230-233.
11.	Sivrikoz CM, Kaya T, Tulay CM, et al. Effective approach for the treatment of bronchopleural fistula:application of endovascular metallic ring-shaped coil in combination with fibrin glue. Ann Thorac Surg, 2007, 83(6):2199-2201.
12.	Keckler SJ, Spilde TL, St Peter SD, et al. Treatment of bronchopleural fistula with small intestinal mucosa and fibrin glue sealant. Ann Thorac Surg, 2007, 84(4):1383-1386.
13.	王征, 王寒冰, 羅全.石碳酸經纖維支氣管鏡滴注治療支氣管胸膜瘺.中國胸心血管外科臨床雜志, 2013, 20(1):78-80.
14.	Takanami I. Closure of a bronchopleural fistula using a fibrin-glue coated collagen patch. Interact Cardiovasc Thorac Surg, 2003, 2(3):387-388.
15.	董天劍, 郭斌.纖維支氣管鏡下OB膠封堵支氣管胸膜瘺五例.中國胸心血管外科臨床雜志, 2004, 11(3):178.
16.	Mora G, de Pablo A, García-Gallo CL, et al. Is endoscopic treatment of bronchopleural fistula useful? Arch Bronconeumol, 2006, 42(8):394-398.
17.	Shekar K, Foot C, Fraser J, et al. Bronchopleural fistula:An update for intensivists. J Crit Care, 2010, 25(1):47-55.
18.	Bellato V, Ferraroli GM, De Caria D, et al. Management of postoperative bronchopleural fistula with a tracheobronchial stent in a patient requiring mechanical ventilation. Intensive Care Med, 2010, 36(4):721-722.
19.	Fernández-Díaz JA, García-Gallo C, Goicolea-Ruigómez J, et al. Use of Amplatzer device for closure of bronchopleural fistulas, a hybrid procedure using bronchoscopy and radiology. Rev Esp Cardiol, 2011, 64(11):1065-1066.
20.	劉興元, 龔太乾, 熊彬.帶蒂肋間肌瓣防治支氣管胸膜瘺17例臨床分析.中國胸心血管外科臨床雜志, 2011, 18(2):177-178.
21.	Carbajo M, Valdivia CD, Jose MNG. Conservative treatment of post-lobectomy bronchopleural fistula. Interact Cardiovasc Thorac Surg, 2012, 15(1):152-154.

1. Wertzel H, Bonnet R, Swoboda L, et al. Chief editor. Postoperative bronchial stump fistula-treatment with fibrin glue and spongy bone graft. Fibrin Sealing in Surgical and Nonsurgical Fields. 1th ed. Berlin Heidelberg:Springer-Verlag, 1995. 194-200.
2. Shields TW, General features and complications of pulmonary resections. General Thoracic Surgery. 4th ed. Baltimore:Williams and Wilkins, 1994. 407-409.
3. McManigle JE, Fletcher GL, Tenholder MF. Bronchoscopy in the management of bronchopleural fistula. Chest, 1990, 97(5):1235-1238.
4. Baumann MH, Sahn SA. Medical management and therapy of bronchopleural fistulas in the mechanically ventilated patient. Chest, 1990, 97(3):721-728.
5. Nagahiro I, Aoe M, Sano Y, et al. Bronchopleural fistula after lobectomy for lung cancer. Asian Cardiovasc Thorac Ann, 2007, 15(1):45-48.
6. Sirbu H, Busch T, Aleksic I, et al. Bronchopleural fistula in the surgery of non-small cell lung cancer:incidence, risk factors, and management. Ann Thorac Cardiovasc Surg, 2001, 7(6):330-336.
7. Cooper WA, Miller JI Jr. Management of bronchopleural fistula after lobectomy. Semin Thorac Cardiovasc Surg, 2001, 13(1):8-12.
8. Hollaus HP, Law F, El-Nashef BB, et al. Natural history of bronchopleural fistula after pneumonectomy:a review of 96 cases. Ann Thorac Surg, 1997, 63(5):1391-1397.
9. Sarkar P, Chandak T, Shah R, et al. Diagnosis and management bronchopleural fistula. Indian J Chest Dis Allied Sci, 2010, 52(2):97-104.
10. Baumann WR, Ulmer JL, Ambrose PG, et al. Closure of a bronchopleural fistula using decalcified human spongiosa and a fibrin sealant. Ann Thorac Surg, 1997, 64(1):230-233.
11. Sivrikoz CM, Kaya T, Tulay CM, et al. Effective approach for the treatment of bronchopleural fistula:application of endovascular metallic ring-shaped coil in combination with fibrin glue. Ann Thorac Surg, 2007, 83(6):2199-2201.
12. Keckler SJ, Spilde TL, St Peter SD, et al. Treatment of bronchopleural fistula with small intestinal mucosa and fibrin glue sealant. Ann Thorac Surg, 2007, 84(4):1383-1386.
13. 王征, 王寒冰, 羅全.石碳酸經纖維支氣管鏡滴注治療支氣管胸膜瘺.中國胸心血管外科臨床雜志, 2013, 20(1):78-80.
14. Takanami I. Closure of a bronchopleural fistula using a fibrin-glue coated collagen patch. Interact Cardiovasc Thorac Surg, 2003, 2(3):387-388.
15. 董天劍, 郭斌.纖維支氣管鏡下OB膠封堵支氣管胸膜瘺五例.中國胸心血管外科臨床雜志, 2004, 11(3):178.
16. Mora G, de Pablo A, García-Gallo CL, et al. Is endoscopic treatment of bronchopleural fistula useful? Arch Bronconeumol, 2006, 42(8):394-398.
17. Shekar K, Foot C, Fraser J, et al. Bronchopleural fistula:An update for intensivists. J Crit Care, 2010, 25(1):47-55.
18. Bellato V, Ferraroli GM, De Caria D, et al. Management of postoperative bronchopleural fistula with a tracheobronchial stent in a patient requiring mechanical ventilation. Intensive Care Med, 2010, 36(4):721-722.
19. Fernández-Díaz JA, García-Gallo C, Goicolea-Ruigómez J, et al. Use of Amplatzer device for closure of bronchopleural fistulas, a hybrid procedure using bronchoscopy and radiology. Rev Esp Cardiol, 2011, 64(11):1065-1066.
20. 劉興元, 龔太乾, 熊彬.帶蒂肋間肌瓣防治支氣管胸膜瘺17例臨床分析.中國胸心血管外科臨床雜志, 2011, 18(2):177-178.
21. Carbajo M, Valdivia CD, Jose MNG. Conservative treatment of post-lobectomy bronchopleural fistula. Interact Cardiovasc Thorac Surg, 2012, 15(1):152-154.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Endobronchial Naso-bronchial Lavage for Post-lobectomy Bronchopleural Fistula: A Case Control Study

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