Endoscopic treatment of bronchopleural fistulas

Ann Thorac Surg. 1998 Mar;65(3):807-9. doi: 10.1016/s0003-4975(97)01427-6.

Abstract

Background: Bronchial fistula is one of the most serious complications of pulmonary resection.

Methods: We present an endoscopic treatment that consists of multiple submucosal injections of polidocanol-hydroxypoliethoxidodecane (Aethoxysklerol Kreussler) on the margins of the fistula using an endoscopic needle inserted through a flexible bronchoscope.

Results: From 1984 to 1995, 35 consecutive nonselected patients with a postresectional bronchopleural fistula were treated. All 23 partial postpneumonectomy or postlobectomy bronchopleural fistulas, ranging from 2 to 10 mm in diameter, healed completely. This did not occur in the 12 total bronchial dehiscences. No complications occurred due to the injection of the drug.

Conclusions: In our opinion this treatment can be considered a valid therapeutic approach, as it is simple, safe, scarcely traumatic, and inexpensive, particularly considering that, in patients in stable condition, it can be performed as an outpatient treatment.

MeSH terms

  • Bronchial Fistula / etiology
  • Bronchial Fistula / surgery*
  • Bronchoscopy
  • Endoscopy / methods*
  • Fistula / etiology
  • Fistula / surgery*
  • Humans
  • Injections
  • Lung Neoplasms / surgery
  • Pleural Diseases / etiology
  • Pleural Diseases / surgery*
  • Pneumonectomy
  • Polidocanol
  • Polyethylene Glycols / administration & dosage
  • Postoperative Complications
  • Surgical Wound Dehiscence
  • Tissue Adhesives / therapeutic use
  • Treatment Outcome

Substances

  • Tissue Adhesives
  • Polidocanol
  • Polyethylene Glycols