The management of bronchopleural fistulas

Padhi, Rasmiranjan; Lynn, R. B.

doi:10.1016/s0022-5223(20)31844-4

Cited by 40 publications

(5 citation statements)

References 5 publications

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“…Cutting the sternochondral cartilage or ribs is likely to lead to complications in repair or wound healing [ 31 , 32 ]. To avoid rupture of the brachiocephalic venous truncus or opening of the pleura, both major complication risks, the opening of the sternum must be done in slow progressive increments with a retractor [ 31 , 33 ]. Another common source of complication is incorrect placement of the drainage tubes at the end of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Sternotomy Approach to the Anterior Cervicothoracic Spine

Chacon¹,

Covarrubias²,

Sarno³

et al. 2021

Cureus

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The anterior cervicothoracic spine is a challenging region to approach given the various vascular, osseous, nervous, and articular structures, which prevent adequate exposure. This region is susceptible to lesions ranging from tumors, degenerative disease, infectious processes, and traumatic fractures. Our objective was to critically evaluate the sternotomy approach in spine surgery to give the technical implications of its usage. The safety and efficacy of the transsternal approach are discussed as well as the advantages, disadvantages, indications, and contraindications. The transsternal approach is the most direct access to pathologies in the upper anterior cervicothoracic spine and enables the spine surgeon to gain direct exposure to the cervicothoracic junction for ideal visualization. Anatomical considerations must be kept in mind while performing a sternotomy to prevent complications such as denervation or bleeding. This technique is useful for the armamentarium of spinal surgeons.

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Section: Discussionmentioning

confidence: 99%

Sternotomy Approach to the Anterior Cervicothoracic Spine

Chacon¹,

Covarrubias²,

Sarno³

et al. 2021

Cureus

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“…The management of bronchopleural fistula is difficult and includes several options such as vacuum therapy alone or associated with bronchial suture, thoracoplasty, latissimus dorsi muscle transposition, a standard repeat thoracotomy, an anterior thoracotomy via a transpericardial route, a transsternal transpericardial approach, and video-mediastinoscopic bronchial stump resection with closure at the carina. 7,17,18 In the case of a left main bronchial stump problem, a right-sided thoracotomy approach has been used successfully. 19…”

Section: Discussionmentioning

confidence: 99%

Postpneumonectomy bronchial stump recurrence and bronchopleural fistula

Cariati

Piromalli

Taviani

2012

Asian Cardiovasc Thorac Ann

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“…Retraction of the superior vena cava and aorta laterally provide sufficient exposure to make a successful repairment. It is also possible to achieve transpericardial approach by anterior thoracic incision with division of multiple costal cartilages which was described by Padhi and Lynn [22]. This approach was found to be a difficult and complicated compared to transsternal approach.…”

Section: Transsternal Transpericardial Approachmentioning

confidence: 99%

Bronchopleural Fistula: Causes, Diagnoses and Management

Batıhan¹,

Ceylan²

2020

Diseases of Pleura

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Bronchopleural fistula (BPF) is a pathological communication between the bronchial tree and pleural space. This clinical condition, which has high mortality and morbidity, is one of the major therapeutic challenges for clinicians even today. BPF may result from a lung neoplasm, necrotizing pneumonia, empyema, blunt and penetrating lung injuries, and a complication of surgical procedures. Lung resection is the most common cause of BPF, and this chapter will focus more on this topic. Frequency ranges from 4.5 to 20% after pneumonectomy and from 0.5 to 1% after lobectomy. Several risk factors have been defined in the development of postoperative BPF; preoperative radiotherapy, pulmonary infection, diabetes, right pneumonectomy, a long bronchial stump, residual cancer at the stump (R1 and R2 resection), and the need for postoperative ventilation (especially with high PEEP). BPFs are divided, based on the time elapsed since surgery, into early or late fistula. This grouping is important in management of patient treatment. In early BPF, surgical treatment is generally the preferred treatment modality, whereas in late BPF, conservative approach is preferred. The management of BPF is still one of the most complex challenges encountered by the thoracic surgeons; so prevention is the best way to manage postoperative BPF.

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The management of bronchopleural fistulas

Cited by 40 publications

References 5 publications

Sternotomy Approach to the Anterior Cervicothoracic Spine

Sternotomy Approach to the Anterior Cervicothoracic Spine

Postpneumonectomy bronchial stump recurrence and bronchopleural fistula

Bronchopleural Fistula: Causes, Diagnoses and Management

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