ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Bronchopleural fistulas: a challenging complication, results of 50 patients
Serkan Yazgan, Soner Gürsoy, Banu Yoldaş, Ahmet Üçvet, Ozan Usluer
Dr. Suat Seren Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, İzmir, Türkiye
DOI : 10.5606/tgkdc.dergisi.2016.12001
Background: This study aims to analyze patients who developed bronchopleural fistula after lung resection in terms of the administered treatment methods and results.

Methods: Of 1,520 patients, who were performed lobectomy or pneumonectomy in our clinic between January 2004 and December 2014, we retrospectively analyzed 50 patients (48 males, 2 females; mean age 57.9 years; range 27 to 74 years) who developed bronchopleural fistula in the follow-up process. We evaluated patients in terms of demographic data, methods of bronchial closure, time of detection of bronchopleural fistula, type of resection, and management of bronchopleural fistula.

Results: Total rate of bronchopleural fistula in the study was 3.2% and median follow-up duration was 40.9 months (range 0 to 121 months). From the 50 patients, 40 (80%) were performed pneumonectomy and 10 (20%) lobectomy; while for bronchial closure, stapler was performed in 37 patients (74%) and manual closure in 13 patients (26%). Patients were divided into three groups according to the time of detection of bronchopleural fistula as acute (n=7), subacute (n=11), and chronic (n=32). Thirty three patients (66%) died during follow-up. Number of patients who died due to bronchopleural fistula was 14 (28%). Rethoracotomy was performed in 10 (20%) patients who were detected in acute and subacute periods. Of these, five died in postoperative period. Of the other five patients, we detected recurrence in three. Surgical intervention was successful in two (20%) patients. The number of surviving patients was 17 (34%) and five-year survival rate was 39.5%.

Conclusion: Due to high morbidity and mortality rates, the management of bronchopleural fistulas which develop after lung resection do not yield satisfactory results. The success rate of surgical interventions performed even in early period is low. Rather than treatment, showing utmost care to prevent the development of bronchopleural fistulas may be the most important management strategy.

Keywords : Bronchopleural fistula; resection; treatment
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