Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success
Abstract Background The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success. Methods We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative broncho...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-05-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.14404 |
| _version_ | 1818056340476526592 |
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| author | Young Ho Yang Seong Yong Park Ha Eun Kim Byung Jo Park Chang Young Lee Jin Gu Lee Dae Joon Kim Hyo Chae Paik |
| author_facet | Young Ho Yang Seong Yong Park Ha Eun Kim Byung Jo Park Chang Young Lee Jin Gu Lee Dae Joon Kim Hyo Chae Paik |
| author_sort | Young Ho Yang |
| collection | DOAJ |
| description | Abstract Background The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success. Methods We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity. Results Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07). Conclusions There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair. |
| first_indexed | 2024-12-10T12:27:17Z |
| format | Article |
| id | doaj.art-e60cc218ede54ea7ad5e4712a41cf47d |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-10T12:27:17Z |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-e60cc218ede54ea7ad5e4712a41cf47d2022-12-22T01:48:57ZengWileyThoracic Cancer1759-77061759-77142022-05-011391401140510.1111/1759-7714.14404Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its successYoung Ho Yang0Seong Yong Park1Ha Eun Kim2Byung Jo Park3Chang Young Lee4Jin Gu Lee5Dae Joon Kim6Hyo Chae Paik7Department of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaDepartment of Thoracic and Cardiovascular Surgery Yonsei University College of Medicine, Severance Hospital Seoul Republic of KoreaAbstract Background The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success. Methods We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity. Results Twenty‐five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07). Conclusions There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair.https://doi.org/10.1111/1759-7714.14404bronchopleural fistulalung transplantmechanical ventilationomental flappulmonary resection |
| spellingShingle | Young Ho Yang Seong Yong Park Ha Eun Kim Byung Jo Park Chang Young Lee Jin Gu Lee Dae Joon Kim Hyo Chae Paik Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success Thoracic Cancer bronchopleural fistula lung transplant mechanical ventilation omental flap pulmonary resection |
| title | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
| title_full | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
| title_fullStr | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
| title_full_unstemmed | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
| title_short | Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success |
| title_sort | postoperative bronchopleural fistula repair surgical outcomes and adverse factors for its success |
| topic | bronchopleural fistula lung transplant mechanical ventilation omental flap pulmonary resection |
| url | https://doi.org/10.1111/1759-7714.14404 |
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