Bronchopleural Fistulas

Lois, Manuel; Noppen, Marc

doi:10.1378/chest.128.6.3955

Cited by 366 publications

(151 citation statements)

References 73 publications

Supporting

Mentioning

149

Contrasting

Unclassified

Order By: Relevance

“…Other minimally invasive treatment options include the use of one-way endobronchial valves that are also used for the treatment of emphysema (Spiration and Zephyr) and endobronchial Watanabe spigots [12,13,14]. The degree of success is variable and depends on the underlying disease and the proximity and size of the fistulae, with larger fistulae having poor closure rates [7,8,9,10,11]. A large BPF is apparently particularly challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic treatment of BPF is based on the delivery of biological glue, coils, covered stents and sealants to the BPF site [5,6,7,8,9,10,11,12,13,14]. The degree of success with bronchoscopic treatment is variable, and depends on the underlying disease, and the proximity and size of the fistulas, with larger fistulas having poor closure rates [6,7,8,9]. In previous reports [15,16], our group described a novel method to close large BPF in 12 patients using the Amplatzer septal and ductal occlusion that is traditionally used for transcatheter closure of atrial septal defects and patent ductus arteriosum.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

et al. 2014

View full text Add to dashboard Cite

Background: The development of a bronchopleural fistula (BPF) is associated with high rates of morbidity and mortality. We have developed a minimally invasive method of bronchoscopic BPF closure using Amplatzer devices (AD) and Amplatzer vascular plugs (AVP), with excellent short-term results. Objectives: The aim of the present report was to explore the long-term outcome of patients treated by Amplatzer occluders and the durability of this novel modality of BPF treatment. Methods: A total of 31 central BPF in 31 patients (mean age 66.8 years, range 19-91) were sealed under moderate sedation bronchoscopically by either AD (n = 19) or AVP (n = 12). The average follow-up period was 17.6 months (range 1-68 months). Results: The main etiology for BPF was surgery (n = 24), pneumonectomy (n = 14) or lobectomy/segmentectomy (n = 10). The underlying disease was either primary (n = 19) or metastatic (n = 2) lung cancer. The immediate success rate was 96% as symptoms related to BPF disappeared in 30 of the 31 patients. Short-term (<30 days) mortality was 13% (4 patients). At follow-up, 14 patients (45%) are still alive. Out of 12 patients with late mortality, in 5 patients (41%) the death was directly related to cancer relapse, and no patient died due to BPF recurrence. Conclusion: Endobronchial closure of BPF using both types of Amplatzer occluders (AD and AVP) is a minimally invasive effective modality of treatment with high safety profile and satisfactory long-term outcome considering the poor prognosis in this particular group of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

et al. 2014

View full text Add to dashboard Cite

show abstract

“…All consecutive patients with persistent air leaks due to large (ranging from 4 to 8 mm) and chronic BPF were included in the analysis. A “chronic fistula” was defined as a postoperative complication without life-threatening event [1,2]. Patients with smaller air leaks treated conservatively have been described in a previous study and were excluded [5].…”

Section: Methodsmentioning

confidence: 99%

“…For inoperable patients, conservative endoscopic procedures are the only therapeutic option to obtain complete closure of the bronchial stump. The success of the conservative procedure depends on the site, morphology, and size of the fistula [1]. A plethora of endoscopic devices, including submucosal injection of inert or irritating substances and instillation of glues or sealants, have proven successful in small and recent BPF [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…A plethora of endoscopic devices, including submucosal injection of inert or irritating substances and instillation of glues or sealants, have proven successful in small and recent BPF [2,3]. In large or chronic BPF, temporary fistula closure has been reported after the placement of endoscopic devices (metallic, silicone, and Amplatzer devices) or spongy calf bone [1,2,3,4]. This allows improving the patient's condition for eventual surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Use of Polyvinyl Alcohol Sponge and Cyanoacrylate Glue in the Treatment of Large and Chronic Bronchopleural Fistulae following Lung Cancer Resection

et al. 2017

View full text Add to dashboard Cite

Background: Bronchopleural fistulae represent a relatively rare complication of pulmonary resection. For inoperable patients, several endoscopic procedures have been described. In the presence of large and chronic bronchopleural fistulae, persistent air leaks require a surgical therapy, while endoscopic airway stent represents a useful palliative treatment. Objective: We describe the successful closure of large and chronic bronchopleural fistulae using an expandable polyvinyl alcohol (PVA) sponge and cyanoacrylate glue. Methods: In all patients, a rigid bronchoscope was used to insert a small cylinder of PVA sponge within the fistula. After releasing the patch, cyanoacrylate glue was applied directly on the PVA sponge using a channel catheter. This methodology induces an expansion of the clot and the closure of the air leak. The long-term outcome of treatment was checked by flexible bronchoscopy once every month for 3 months and every 6 months until 5 years. Results: We performed endoscopic treatment in 7 consecutive patients with bronchopleural fistula ranging from 4 to 8 mm. In 6 of 7 patients, the bronchial stump was the site of the fistula. In 1 patient, the fistula was visualized on the right wall of the distal trachea. A temporary complete occlusion of the fistula was achieved in 7 of 7 patients and a definitive result in 5 of 7 patients. Conclusions: The use of an expandable PVA sponge and cyanoacrylate glue is an available strategy for endobronchial closure of bronchopleural fistulae.

show abstract