scholarly journals Closure of the bronchial stump by manual suture and incidence of bronchopleural fistula in a series of 209 pneumonectomies for lung cancer

1999 ◽  
Vol 16 (4) ◽  
pp. 418-423 ◽  
Author(s):  
J.-J. Hubaut ◽  
O. Baron ◽  
O. Al Habash ◽  
Ph. Despins ◽  
D. Duveau ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Bronchopleural Fistula ◽  
Bronchial Stump ◽  
Manual Suture

scholarly journals Preventive esophagomyobronchoplasty as a method to prevent the failure of the bronchial stump in pneumonectomy for lung cancer

2021 ◽  
Vol 102 (6) ◽  
pp. 940-945
Author(s):  
R A Sulimanov ◽  
R R Sulimanov ◽  
E S Spassky ◽  
T V Fedorova ◽  
M A Kholodova
Keyword(s):  
Lung Cancer ◽  
Retrospective Analysis ◽  
High Efficiency ◽  
Clinical Group ◽  
Case Histories ◽  
Bronchial Stump ◽  
Manual Suture ◽  
Mechanical Suture ◽  
Suturing Techniques ◽  
Suture Failure

Aim. Comparative analysis of insufficiency rate of bronchial stump sutures in pneumonectomy for lung cancer, depending on suturing techniques. Methods. A patented technique for bronchial stump suturing has been introduced into the practice of the GOBUZ clinic Novgorod Regional Clinical Hospital based on the Department of thoracic surgery since 2015 for pneumonectomy for lung cancer. Before the introduction of the developed technique, various generally accepted methods of bronchial stump forming were used (mechanical suture, manual suture, their combination, bronchial stump coverage with mediastinal pleura, pericardial flap). A retrospective analysis of 173 case histories and operational protocols of patients with lung cancer who underwent pneumonectomy was carried out for the failure of bronchial stump sutures when using conventional suturing techniques between 2010 and 2014 (the first group of patients). We also performed a retrospective and prospective analysis of 204 case histories and operational protocols of patients in a similar clinical group when using a patented suturing technique between 2015 and 2020 (the second group of patients). Statistical analysis was carried out by using Statistica 10.0 software (StatSoft, Inc. 2011). The qualitative and quantitative indicators were analyzed by using the Pearsons 2-test with Yatess correction. Results. A retrospective analysis shows that the failure rate in the use of generally accepted bronchial stump suturing techniques for 20102014 was 10.4%. After the implementation of the method of preventive esophagobronchomyoplasty, complications as bronchial stump suture failure were not detected in any case between 2015 and 2020. Conclusion. The study shows high efficiency, a decrease in the incidence of complications as the failure of bronchial stump sutures in the use of the developed method of preventive esophagomyobronchoplasty in pneumonectomy for lung cancer.

scholarly journals Is the flap reinforcement of the bronchial stump really necessary to prevent bronchial fistula?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Fatmir Caushi ◽  
Gentiana Qirjako ◽  
Ilir Skenduli ◽  
Daniela Xhemalaj ◽  
Hasan Hafizi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Resection ◽  
Bronchopleural Fistula ◽  
Neoadjuvant Treatment ◽  
Bronchial Stump ◽  
Study Results

Abstract Background/aim The development of bronchopleural fistula (BPF) remains the most severe complication of lung resection, especially after pneumonectomy. Studies provide controversial reports regarding the benefits of flap reinforcement of the bronchial stump (FRBS) in preventing BPF’s occurrence. Methods This is a retrospective cohort study of 558 patients that underwent lung resection in a 12-year period (from 2007 to 2018). Ninety patients (16.1%) underwent pneumonectomy. Patient follow-up period varied from 1 to 12 years. Results Out of 558 patients in this study, 468 (83.9%) underwent lobectomy, and the remnant underwent pneumonectomy. In 114 cases with lobectomy, only 24.4% had FRBS, meanwhile in 56 cases with pneumonectomy only 62.2% had FRBS. BPF occurred in 8 patients with lobectomy (1.7%) and in 10 patients with pneumonectomy (11.1%). Among cases with post-pneumonectomy BPF, 6 (10.7%) had FRBS performed, while no FRBS was performed among patients with post-lobectomy BPF, although these data weren’t statistically (p > 0.05). In 24 patients (20 lobectomies and 4 pneumonectomies) with lung cancer (10.4%) neoadjuvant treatment was performed, in which 20 patients underwent chemotherapy and 4 underwent radiotherapy. FRBS was applied in each of the above 24 operative cases, but only in 4 of them the BPF was verified. Conclusion The idea of enhancing the blood supply through the FRBS for BPF prevention has gain traction. Although FRBS has been identified as valuable and effective method in BPF prevention following lung resection, our study results did not support this evidence.

Methods of main bronchus stump closure and incidence of bronchopleural fistula after pneumonectomies for lung cancer (a retrospective single center review)

2014 ◽  
Vol 20 (4) ◽  
pp. 183-189
Author(s):  
Saulius Cicėnas ◽  
Algirdas Jackevičius ◽  
Renatas Aškinis ◽  
Arnoldas Krasauskas ◽  
Nerijus Šileika ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Mediastinal Lymph Node ◽  
Main Bronchus ◽  
Bronchopleural Fistula ◽  
Bronchial Stump ◽  
Lung Cancer Patients ◽  
Lymph Node Sampling ◽  
Stump Closure

Background. Bronchopleural fistulas (BPFs) development after pneumo­nectomy remains a serious complication and is associated with high mortality rate. We evaluated incidence and risk factors, that influenced BPF rate after pneumonectomies for lung cancer patients treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University, and compared different bronchial stump suturing techniques. Methods. It is a retrospective study. We reviewed 580 lung cancer patients who underwent pneumonectomies from January 1990 to January 2009. The average patient’s age was 60.1 ± 7.9 years (range from 34 to 76). Patients according to postoperative staging: stage IIA – 30 patients, IIB – 80, IIIA – 320, IIIB – 96, IV – 54. The most common tumor histology was planocellular carcinoma – 301, adenocarcinoma – 108, small-cell carcinoma – 76. Results. There were 327 (56.4%) right and 253 (43.6%) left pneumonectomies. Mediastinal lymph node dissection (LND) was performed to 387 (66.7%) and lymph node sampling (LNS) to 193  (33.3%) patients. The bronchial stump was covered in 285 (49.1%) patients. Bronchopleural fistula after pneumonectomy developed in 48 (8.3%) patients (bronchial dehiscence was confirmed by bronchoscopy), and 7 patients with BPF died (14.5%). BPF after right pneumonectomy occurred in 30 cases (9.5%) and after left pneumonectomy in 18 cases (7.1%), the difference was not statistically significant (p > 0.05). BPF after LND occurred in 38 cases (9.82%) and after LNS in 10 cases (5.18%), the dif­f erence was statistically significant (p 

scholarly journals Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

2014 ◽  
Vol 41 (3) ◽  
pp. 188-192
Author(s):  
Vitor Mayer de Moura ◽  
Erinaldo Rocha Paes Lamdim ◽  
Felipe Souza Ferraz ◽  
Rodrigo Carvalho Turatti ◽  
Carolina de Barros Jaqueta ◽  
...  
Keyword(s):  
Experimental Study ◽  
The Other ◽  
Compressed Air ◽  
Air Leak ◽  
Bronchial Stump ◽  
Modified Method ◽  
Tracheal Pressure ◽  
Air Ventilation ◽  
Manual Suture ◽  
Isolated Trachea

OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump. METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg. RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08). CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

scholarly journals Case Report: COVID-19 Pneumonia Following Left Pneumonectomy for Lung Cancer Complicated by Empyema and Bronchopleural Fistula

2021 ◽  
Vol 8 ◽  
Author(s):  
Alberto Testori ◽  
Veronica M. Giudici ◽  
Marco Alloisio ◽  
Ugo Cioffi
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Data ◽  
Pulmonary Thromboembolism ◽  
Bronchopleural Fistula ◽  
Case Presentation ◽  
Arterial Thromboembolism ◽  
Left Pneumonectomy

Background: Venous and arterial thromboembolism is commonly reported in critically ill COVID-19 patients, although there are still no definitive statistical data regarding its incidence.Case presentation: we report a case of a patient who fell ill with Covid during hospitalization for a pneumonectomy complicated by empyema and bronchopleural fistula. The patient, despite being cured of COVID, died after 14 days for pulmonary thromboembolism.Conclusion: Our case strengthens the suggestion of adequate thromboprophylaxis in all hospitalized COVID patients and of increasing prophylaxis in critically ill patients even in the absence of randomized studies

scholarly journals Herniation of Packing Material into a Bronchopleural Fistula after Right Pneumonectomy and Clagett Window

2018 ◽  
Vol 8 ◽  
pp. 17
Author(s):  
Iclal Ocak ◽  
Gideon Bollino ◽  
Diane Strollo
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Bronchopleural Fistula ◽  
Packing Material ◽  
Advanced Lung Cancer ◽  
Chest Cavity ◽  
Open Chest ◽  
Important Clue

Diagnosis of a bronchopleural fistula (BPF) can be challenging in patients after pneumonectomy and Clagett window. Herein, we present a case of pneumonectomy for advanced lung cancer complicated by a BPF. Herniation of packing material from the open-chest cavity into the fistula and airways on computed tomography was an important clue to making the diagnosis.

Bronchial Stump Protection and Incidence of Bronchopleural Fistula

1995 ◽  
pp. 204-206
Author(s):  
G. Gotti ◽  
M. M. Haid ◽  
P. Paladini ◽  
L. Voltolini ◽  
M. Di Bisceglie ◽  
...  
Keyword(s):  
Bronchopleural Fistula ◽  
Bronchial Stump

Fibrin Glue Administration to Support Bronchial Stump Line

2008 ◽  
Vol 16 (6) ◽  
pp. 450-453 ◽  
Author(s):  
Soner Gursoy ◽  
Murat U Yapucu ◽  
Ahmet Ucvet ◽  
Serkan Yazgan ◽  
Oktay Basok ◽  
...  
Keyword(s):  
High Risk ◽  
Fibrin Glue ◽  
Pulmonary Resection ◽  
Bronchopleural Fistula ◽  
Surgical Margin ◽  
Postoperative Mortality ◽  
Lung Abscess ◽  
Bronchial Stump ◽  
Neoadjuvant Radiotherapy ◽  
Mortality And Morbidity

Bronchopleural fistula is an important cause of mortality and morbidity after pulmonary resection. The use of fibrin glue to reduce the tension and number of sutures in the bronchial stump was assessed in this prospective study of 20 patients between June 2002 and May 2003. They all had a high risk of bronchopleural fistula development because of bronchiectasis, tuberculosis, lung abscess, diabetes mellitus, preoperative neoadjuvant radiotherapy, or residual tumor at the surgical margin. After pulmonary resection, the bronchial stump was closed with separate nonabsorbable sutures supported with fibrin glue. Bronchopleural fistula was observed in only 1 (5%) patient during 6.45 ± 3.09 months of follow-up. There was no postoperative mortality. Closing the bronchial stump with an appropriate technique and supporting it with fibrin glue were considered effective in preventing bronchopleural fistula development after pulmonary resection in high-risk patients.

Sign in / Sign up

Export Citation Format

Share Document