BACKGROUND Bronchopleural fistula (BPF) is a relatively rare, but severe complication of pulmonary tuberculosis. It is associated with significant mortality; however, its management remains a major therapeutic challenge. CASE SUMMARY We present a 24-year-old man with BPF resulting from severe pulmonary tuberculosis combined with mixed infections. The damaged right upper lobe and concomitant empyema were demonstrated via computed tomography. After undergoing open-window thoracostomy and tuberculosis treatment for 4 mo, decortication and right upper lobectomy were subsequently performed, leading to the resolution of tuberculosis and other concurrent pulmonary infections. Follow-up, 6 mo after surgery, failed to reveal any evidence of infection recurrence resulting in a good prognosis. CONCLUSION The disease course of tuberculous BPF is particularly challenging. Surgical intervention serves as an effective and safe therapeutic strategy for BPF.

Background Surgery is a crucial component of the management of chronic pulmonary aspergillosis (CPA).However, there is currently less information available on Uni-port thoracoscopy(Uni-VATS) for CPA.Therefore, we created a single-center retrospective analysis of surgical procedures for CPA to demonstrate the effectiveness and security of Uni-VATS in CPA. Methods The basic information and surgical data of patients who underwent surgery at our hospital from January 2018 to June 2022 for CPA were obtained, all of whom received voriconazole antifungal medication for 3-6 months following surgery and were monitored for more than 6 months. Results A total of 110 patients met the inclusion criteria, including 59 cases in the traditional open chest incision group and 51 cases in the Uni-VATS group. There was one death among all patients due to pulmonary infection after surgery in our hospital.The mean operative time in the traditional open chest incision group and Uni-VATS group was 321.90±92.16 and 233.12±113.65 minutes, respectively.In the two groups mentioned above, the median (IQR) of intraoperative blood loss volume was 450(300-1000) and 330(100-500) ml,postoperative 24-hour drainage volume was 520(320-820) and 200(120-400) ml, postoperative second 24-hour drainage volume was 420(260-650) and 170(100-300) ml, pain scores were 9(8-10) and 4(4-5), postoperative drainage tube removal time was 15(8-21) and 8(5-16) days,postoperative hospital stay time was 18(13-23) and 12(8-18) days, and postoperative complication rate was 40.7%(24/59) and 17.6%(9/51) respectively. ConclusionUni-VATS is highly effective safe and minimally invasive for patients with CPA, and could be suggested as an alternative to traditional methods of lung surgery.