Endobronchial-Guided Vascularized Tissue Flaps for a Bronchopleural Fistula

Area of Science:

• Thoracic Surgery
• Pulmonology
• Surgical Oncology

Background:

• Bronchopleural fistula (BPF) management presents significant clinical challenges.
• Conservative measures are typically the first line of treatment for BPF.
• Refractory cases may necessitate surgical intervention, including vascularized pedicled flaps.

Observation:

• A 67-year-old male patient with stage IIIa squamous cell lung carcinoma underwent lower and middle bilobectomy post-neoadjuvant chemoradiation.
• The patient developed postoperative complications, including empyema and a bronchopleural fistula.
• Accessing the fistula for treatment proved difficult.

Findings:

• Endobronchial-guided vascularized tissue flaps were employed to manage the challenging BPF.
• This minimally invasive approach resulted in successful closure of the bronchopleural fistula.
• The technique provided an effective solution when traditional access was limited.

Implications:

• This case highlights the potential of endobronchial vascularized tissue flaps as a viable therapeutic option for complex BPF.
• The findings suggest this technique can overcome challenges associated with fistula accessibility.
• Further research into this endobronchial approach may refine BPF treatment strategies.