A novel guidewire technique for endobronchial silicone plug occlusion for bronchopleural fistula

2021 ◽  
Keyword(s):  
Bronchopleural Fistula ◽  
Chemoradiation Therapy ◽  
Fistula Closure ◽  
Accurate Localization ◽  
Working Space ◽  
Device Implantation ◽  
Left Upper Lobectomy ◽  
Placement Technique

Successful bronchoscopic bronchopleural fistula closure requires both accurate localization of the fistula and device implantation; placing a silicone plug requires experience and skill because of the limited endobronchial working space. We report a novel bronchoscopic silicone plug placement technique for a bronchopleural fistula that developed after a left upper lobectomy following induction chemoradiation therapy, which was then successfully treated by omentopexy.

scholarly journals Innovative method for Amplatzer device implantation in patients with bronchopleural fistulas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jisong Zhang ◽  
Huihui Hu ◽  
Li Xu ◽  
Shan Xu ◽  
Jihong Zhu ◽  
...  
Keyword(s):  
Present Report ◽  
Rare Complication ◽  
Bronchopleural Fistula ◽  
Rigid Bronchoscopy ◽  
New Approach ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Field Of Vision ◽  
Duration Of Operation

Abstract Background Bronchopleural fistula (BPF) is a relatively rare complication after various types of pulmonary resection. The double-sided mushroom-shaped occluder (Amplatzer device, AD) has been gradually used for BPF blocking due to its reliable blocking effect. We have improved the existing AD implantation methods to facilitate clinical use and named the new approach Sheath-free method (SFM). The aim of the present report was to explore the reliability and advantages of the SFM in AD implantation. Methods We improved the existing implantation methods by abandoning the sheath of the AD and using the working channel of the bronchoscope to directly store or release the AD without general anesthesia, rigid bronchoscopy, fluoroscopy, or bronchography. A total of 6 patients (5 men and 1 woman, aged 66.67 ± 6.19 years [mean ± SD]) had BPF blocking and underwent the SFM in AD implantation. Results AD implantation was successfully performed in all 6 patients with the SFM, 4 persons had a successful closure of the fistula, one person died after few days and one person did not have a successful closure of the fistula. The average duration of operation was 16.17 min (16.17 ± 4.67 min [mean ± SD]). No patients died due to operation complications or BPF recurrence. The average follow-up time was 13.2 months (range 10–17 months). Conclusion We observed that the SFM for AD implantation—with accurate device positioning and a clear field of vision—is efficient and convenient. The AD is effective in BPF blocking, and could contribute to significantly improved symptoms of patients.

scholarly journals A novel technique for bronchopleural fistula closure: An hourglass-shaped stent

2009 ◽  
Vol 137 (1) ◽  
pp. e46-e47 ◽  
Author(s):  
Cemal Asim Kutlu ◽  
Suat Patlakoglu ◽  
Ahmet Erdal Tasci ◽  
Oguz Kapicibasi
Keyword(s):  
Bronchopleural Fistula ◽  
Fistula Closure ◽  
Novel Technique

scholarly journals Bronchopleural Fistula Closure With Amplatzer Device

2020 ◽  
Vol 27 (3) ◽  
pp. e41-e45
Author(s):  
Elliot Ho ◽  
Rohit Srivastava ◽  
Pravachan Hegde
Keyword(s):  
Bronchopleural Fistula ◽  
Fistula Closure ◽  
Amplatzer Device

scholarly journals The Amplatzer device and pedicle muscle flap transposition for the treatment of bronchopleural fistula with chronic empyema after lobectomy: two case reports

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yongyong Wu ◽  
Zhongliang He ◽  
Weihua Xu ◽  
Guoxing Chen ◽  
Zhijun Liu ◽  
...  
Keyword(s):  
Case Reports ◽  
Bronchopleural Fistula ◽  
Muscle Flap ◽  
Bronchial Tree ◽  
Chronic Empyema ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Long Time ◽  
Effective Drainage ◽  
Muscle Flap Transposition

Abstract Background Bronchopleural fistula (BPF) refers to an abnormal channel between the pleural space and the bronchial tree. It is a potentially fatal postoperative complication after pulmonary resection and a complex challenge for thoracic surgeons because many patients with BPF ultimately develop refractory empyema, which is difficult to manage and has a major impact on quality of life and survival. Therefore, an operative intervention combined with conservative and endoscopic therapies may be required to control infection completely, to occlude BPF, and to obliterate the empyema cavity during treatment periods. Case presentation Two patients who suffered from BPF complicated with chronic empyema after lobectomy were treated in other hospitals for a long time and did not recover. In our department, we performed staged surgery and creatively combined an Amplatzer Septal Occluder (ASO) device (AGA Medical Corp, Golden Valley, MN, USA) with pedicled muscle flap transposition. First, open-window thoracostomy (OWT), or effective drainage, was performed according to the degree of contamination in the empyema cavity after the local infection was controlled. Second, Amplatzer device implantation and pedicled muscle flap transposition was performed at the same time, which achieved the purpose of obliterating the infection, closing the fistula, and tamponading the residual cavity. The patients recovered without complications and were discharged with short hospitalization stays. Conclusions We believe that the union of the Amplatzer device and pedicle muscle flap transposition seems to be a safe and effective treatment for BPF with chronic empyema and can shorten the length of the related hospital stay.

scholarly journals Bronchopleural fistula closure with vascular plug and intrapleural glue administration

2020 ◽  
Vol 9 (1) ◽  
pp. 106
Author(s):  
Neeraj Sharma ◽  
Vasu Vardhan ◽  
ChandanSingh Katoch ◽  
Aseem Yadav
Keyword(s):  
Bronchopleural Fistula ◽  
Fistula Closure ◽  
Vascular Plug

scholarly journals Innovative Method for Amplatzer Device Implantation in Patients With Bronchopleural Fistulas

2020 ◽  
Author(s):  
Jisong Zhang ◽  
Huihui Hu ◽  
Li Xu ◽  
Shan Xu ◽  
Jihong Zhu ◽  
...  
Keyword(s):  
Present Report ◽  
Rare Complication ◽  
Bronchopleural Fistula ◽  
Rigid Bronchoscopy ◽  
New Approach ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Field Of Vision ◽  
Duration Of Operation

Abstract Background: Bronchopleural fistula (BPF) is a relatively rare complication after various types of pulmonary resection. The double-sided mushroom-shaped occluder (Amplatzer device, AD) has been gradually used for BPF blocking due to its reliable blocking effect. We have improved the existing AD implantation methods to facilitate clinical use and named the new approach the Sheath-free method (SFM the aim of the present report was to explore the reliability and advantages of SFM for AD implantation.Methods: We improved the existing placement methods by abandoning the sheath of the AD and using the working channel of the bronchoscope to directly store or release the AD without the use of general anesthesia, rigid bronchoscopy, fluoroscopy, or bronchography. A total of 6 patients (5 men and 1 woman, aged 66.67±6.19 years [mean ± SD]) had bronchopleural fistulas sealed using the SFM for AD implantation. Results: Closure was successfully performed in all 6 patients with the SFM, and the average duration of operation was 16.17 minutes (16.17±4.67 minutes [mean ± SD]). Five patients achieved complete occlusion after the operation, and 1 patient who had multiple fistulas did not. No patients died due to operation complications and BPF recurrence. The average follow-up time was 13.2 months (range: 10-17 months).Conclusion: We observed that the SFM for AD implantation—with accurate device positioning and a clear field of vision—is efficient and convenient. The AD is effective in BPF sealing, and patient symptoms significantly improved after sealing.

scholarly journals Emergency drain for post pneumonectomy bronchopleural fistula: a drain placement technique based on the siphon principle

2018 ◽  
Vol 10 (1) ◽  
pp. 468-471
Author(s):  
Francesco Petrella ◽  
Alberto Sandri ◽  
Stefania Rizzo ◽  
Alessandro Borri ◽  
Domenico Galetta ◽  
...  
Keyword(s):  
Bronchopleural Fistula ◽  
Drain Placement ◽  
Placement Technique

Right main bronchus para-occluder fistula closure with a septal defect occluder

2019 ◽  
Vol 27 (6) ◽  
pp. 505-508
Author(s):  
Alexander Victorovich Bashenow ◽  
Igor Yakovlevich Motus ◽  
Anna Sergeevna Tsvirenko ◽  
Igor Davydovich Medvinskiy ◽  
Sergey Alexandrovich Dovbnya ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Septal Defect ◽  
Main Bronchus ◽  
Bronchopleural Fistula ◽  
Multidrug Resistant ◽  
Fistula Closure ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

We present a case of successful closure of a para-occluder fistula. The bronchopleural fistula occurred after a right-sided pneumonectomy performed for multidrug-resistant tuberculosis. Initial closure of the bronchopleural fistula with the use of an atrial septal defect occluder 3 years later led to relapse of the fistula after 2 years. To manage the relapsing bronchopleural fistula, we partially destroyed the former nonfunctioning occluder, measured the size of the bronchial defect with a sizing balloon, and installed an atrial septal defect occluder of a larger size.

Bronchopleural Fistula Closure With Amplatzer Device

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 27A
Author(s):  
Amit Goyal ◽  
Sara Greenhill ◽  
Kevin Kovitz ◽  
Neeraj Desai
Keyword(s):  
Bronchopleural Fistula ◽  
Fistula Closure ◽  
Amplatzer Device

Bronchoscopic sclerosis of post-resectional bronchial fistulas

2018 ◽  
Vol 27 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Eduardo Rivo ◽  
Jorge Quiroga ◽  
José-María García-Prim ◽  
Andrés Obeso ◽  
Jose Soro ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Multimodal Treatment ◽  
Pulmonary Resection ◽  
Lung Resection ◽  
Bronchopleural Fistula ◽  
Therapeutic Options ◽  
Fistula Closure ◽  
Flexible Bronchoscope ◽  
Submucosal Injection ◽  
Clinical Records

Background Pulmonary resection is, by far, the primary cause of bronchial fistula. This is a severe complication because of its morbidity and mortality and the related consumption of resources. Definitive closure continues to be a challenge with several therapeutic options, but none are optimal. We describe our experience in bronchoscopic application of ethanolamine and lauromacrogol 400 for the treatment of post-resection bronchial fistulas. Methods Clinical records of 8 patients treated using this technique were collected prospectively. The diagnosis of a fistula was confirmed by flexible bronchoscopy. Sclerosis was indicated in the context of multimodal treatment. Sclerosant injection was performed under general anesthesia with a Wang 22G needle through a flexible bronchoscope. The procedure was repeated at 2-week intervals until definitive closure of the fistula was confirmed. Results Fistula closure was achieved in 7 (87.5%) of the 8 patients, with persistence of the fistula in one patient who could not complete the treatment because of recurrence of his neoplastic pathology. No recurrence or complications related to the technique were registered. Conclusions Bronchoscopic sclerosis by means of submucosal injection of lauromacrogol 400 or ethanolamine should be part of the multimodal treatment of bronchopleural fistula after lung resection, pending further studies that contribute to the accurate establishment of optimal indications for this procedure.

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