Analysis of Risk Factors for Bronchopleural Fistula after Surgical Treatment of Lung Cancer

Tokunaga, Yoshimasa; Kita, Yusuke; Okamoto, Taku

doi:10.5761/atcs.oa.20-00010

Cited by 18 publications

(19 citation statements)

References 27 publications

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“…The above-mentioned reasons can be explained by the influence of the blood supply of the bronchial anastomosis or the stump. Several studies have reported that comorbidities such as diabetes can affect the blood supply to the bronchial anastomosis, delaying healing, and thus being highly associated with the occurrence of BPF (9,11). However, similar results were not observed in the present study.…”

Section: Discussioncontrasting

confidence: 67%

“…Right pneumonectomy and right lower and/or middle lobectomy are risk factors for BPF after bronchoplasty, and have been reported in several previous studies (3,8,9,16,17). In the present study, there were only four patients with pneumonectomy and only one with right pneumonectomy, so the association between right pneumonectomy and the occurrence of BPF was not explored.…”

Section: Discussionmentioning

confidence: 63%

“…Several studies have reported some risk factors related to the occurrence of BPF after lung surgery. Among them, the most reported risk factors include age at surgery (11,26), diabetes (9,11), COPD (27), neoadjuvant therapy (11)(12)(13), albumin level (8,28), as well as intraoperative factors such as residual margin (3), right pneumonectomy (8,17,18,29), and right middle and/or lower lobectomy (8,30). In this study, we used bronchoplasty patients as the study population, and obtained some of the same risk factors as those for the high incidence of BPF after pneumonectomy and lobectomy, such as residual margin and right middle and/or lower lobectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported that compared with routine lobectomy, the incidence of BPF after bronchoplasty is higher (7,8). Several risk factors have been reported to be associated with BPF after lung surgery, such as diabetes mellitus (9)(10)(11), neoadjuvant therapy (11)(12)(13)(14)(15), right pneumonectomy, and right lower lobectomy (3,8,9,(16)(17)(18). However, few studies have focused on the risk factors for BPF after bronchoplasty.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and outcomes of bronchopleural fistula after bronchoplasty in patients with non-small cell lung cancer: a retrospective multivariate analysis

Peng

Mei

Liu

et al. 2022

Transl Lung Cancer Res

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Background: Bronchopleural fistula (BPF) is a rare but severe complication following bronchoplasty.Identification of the risk factors for the development of BPF after bronchoplasty may contribute to better perioperative management, thereby further improving the prognosis of these patients. However, few studies have focused on the risk factors for BPF after bronchoplasty. This study aimed to explore the risk factors and outcomes for BPF after bronchoplasty in patients with non-small cell lung cancer (NSCLC). Methods: The data of NSCLC patients who underwent bronchoplasty between September 2005 and August 2020 in our institution were retrospectively reviewed. Detailed information on demographic characteristics, preoperative assessment, perioperative outcomes were collected from Western China Lung Cancer Database. The diagnosis of BPF was confirmed by bronchoscopy. Risk factors for BPF were assessed by univariate and multivariate logistic regression analysis. Results: A total of 503 patients were included in this study, including 132 (26.2%) cases of bronchovascular plasty, 340 (67.6%) cases of bronchial sleeve lobectomy, and 31 (6.2%) cases of bronchial wedge plasty. Among these patients, 16 (3.2%) developed postoperative BPF. Six patients with BPF died during hospital-stay, including two cases of severe hemoptysis, and four cases of pyothorax and respiratory failure caused by BPF. One of the other ten patients underwent reoperation. After univariate and multivariate logistic regression analysis, preoperative Charlson Comorbidity Index (CCI) ≥2 [odds ratio (OR) =5.120, 95% confidence interval (CI): 1.193-21.985, P=0.028], right middle and/or lower lobectomy (OR =4.840, 95% CI: 1.133-20.686, P=0.033), and residual tumor in the bronchial margin (OR =4.160, 95% CI: 1.106-15.644, P=0.035) were identified as independent risk factors for postoperative BPF.Conclusions: Although complication rate of BPF after bronchoplasty is low, the mortality of BPF is high. Patients with higher CCI, those who undergo right middle and/or lower lobectomy, and those with residual tumor in the bronchial margin are at increased risk of BPF. This study highlights the importance of preoperative evaluation and good intraoperative management to prevent this catastrophic complication.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors and outcomes of bronchopleural fistula after bronchoplasty in patients with non-small cell lung cancer: a retrospective multivariate analysis

Peng

Mei

Liu

et al. 2022

Transl Lung Cancer Res

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“…Therefore, early diagnosis and selection of appropriate treatment methods are life-saving. Risk factors for BPF formation include severe devascularization of the bronchial stump or anastomotic line during resection, leaving a long stump, presence of residual tumor tissue in the stump, neoadjuvant therapies, steroid use, presence of diabetes mellitus, early postoperative pneumonia or empyema, and prolonged postoperative mechanical ventilation [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Akciğer rezeksiyonları sonrası gelişen bronkoplevral fistül tedavisinde omentoplasti

Erdoğu¹,

Aker

Pekçolaklar³

et al. 2021

Cukurova Medical Journal

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ÖzPurpose: Bronchopleural fistula (BPF) is a complication that can occur after pulmonary resections onset may be early or late. This study aims to present our results using omentoplasty in the treatment of BPF. Materials and Methods: We retrospectively evaluated the data of patients who developed BPF after pulmonary resection between 2010 and 2020. The results of the patients who underwent omentoplasty during surgical revision for BPF were analyzed in terms of surgical methods used, timing of the procedure, and surgical success. Results: BPF formed in 52 (2.1%) of 2486 patients who underwent anatomical lung resection. Fourteen (26.9%) of the patients with BPF were treated with omentoplasty. All of the patients were men and the median age was 58 years (range, 27-75 years). Among the patients who underwent omentoplasty, the median time from pulmonary resection to BPF development was 22 days (range, 4-221 days). The median time from BPF development to omentoplasty was 9.5 days (range, 4-485 days). Seven (50%) of the patients developed BPF after pneumonectomy and the other 7 (50%) after lobectomy. Most post-pneumonectomy BPFs occurred after right pneumonectomy (n=6, 85.7%). BPF developing after right pneumonectomy constituted 43% of all BPFs (n=6). Surgical success was achieved in 13 (92.9%) of the 14 patients who underwent BPF closure with omentoplasty. Conclusion:Omentoplasty has low complication and high success rates and can be used safely for the treatment of BPF. Amaç: Bronkoplevral fistül (BPF), akciğer rezeksiyonları sonrasında erken veya geç dönemde oluşabilen bir komplikasyondur. Bu çalışmanın amacı, BPF tedavisinde omentoplasti kullanım sonuçlarını sunmaktır. Gereç ve Yöntem: 2010-2020 yılları arasında akciğer rezeksiyonu sonrası BPF gelişen hastaların verilerini retrospektif olarak değerlendirdik. BPF nedeniyle cerrahi revizyon sırasında omentoplasti yapılan hastaların sonuçları, kullanılan cerrahi yöntemler, işlemin zamanlaması ve cerrahi başarısı açısından analiz edildi. Bulgular: Anatomik akciğer rezeksiyonu yapılan 2486 hastanın 52'sinde (%2.1) BPF gelişti. BPF olan hastaların 14'ü (%26,9) omentoplasti ile tedavi edildi. Hastaların tamamı erkekti ve ortanca yaş 58 (aralık 27-75) idi. Omentoplasti yapılan hastalarda akciğer rezeksiyonundan BPF gelişimine kadar geçen medyan süre 22 gündü (aralık 4-221 gün). BPF gelişiminden omentoplasti işlemine kadar geçen medyan süre 9.5 gündü (aralık 4-485 gün). Hastaların yedisinde (%50) pnömonektomiden sonra BPF gelişirken, diğer 7'sinde (%50) lobektomiden sonra BPF gelişti. Pnömonektomi sonrası BPF'lerin çoğu sağ pnömonektomiden sonra meydana geldi (n=6, %85.7). Sağ pnömonektomi sonrası gelişen BPF, tüm BPF' lerin %43' ünü oluşturmaktaydı (n=6). Omentoplasti ile BPF'ü kapatılan 14 hastanın 13'ünde (%92,9) cerrahi başarı elde edildi. Sonuç: Omentoplasti düşük komplikasyon ve yüksek başarı oranları ile BPF tedavisinde güvenle kullanılabilir.

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Integrated Chinese and Western Medicine in Treatment of Bronchopleural Fistula with Mycobacterium abscessus: A Case Report

Wang,

Cheng,

Ban

et al. 2023

Chin. J. Integr. Med.

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Analysis of Risk Factors for Bronchopleural Fistula after Surgical Treatment of Lung Cancer

Cited by 18 publications

References 27 publications

Risk factors and outcomes of bronchopleural fistula after bronchoplasty in patients with non-small cell lung cancer: a retrospective multivariate analysis

Risk factors and outcomes of bronchopleural fistula after bronchoplasty in patients with non-small cell lung cancer: a retrospective multivariate analysis

Akciğer rezeksiyonları sonrası gelişen bronkoplevral fistül tedavisinde omentoplasti

Integrated Chinese and Western Medicine in Treatment of Bronchopleural Fistula with Mycobacterium abscessus: A Case Report

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