[Bronchial fistula management. Is the exit found?]

Area of Science:

• Thoracic Surgery
• Interventional Pulmonology
• Medical Device Innovation

Background:

• Bronchial fistulas are serious complications following lung surgery.
• Traditional treatments for bronchial fistulas can be invasive and have limited success rates.

Purpose of the Study:

• To evaluate the efficacy of using Atrial Septal Defect (ASD) occluders for treating bronchial fistulas.
• To present a novel minimally invasive treatment option for post-pulmonectomy bronchial fistulas.

Main Methods:

• Eight patients with main bronchus fistulas post-pulmonectomy (for tuberculosis or lung cancer) were treated using ASD occluders.
• Procedures were performed between March 2015 and October 2016, with dual visualization from the pleural cavity and bronchial lumen.
• Occluders, originally designed for septal defects, were adapted for fistulas ranging from 6-26 mm.

Main Results:

• Seven out of eight patients survived the procedure.
• Adequate occlusion was achieved in six patients; one experienced air drainage around the occluder.
• A significant 2-3 fold decrease in residual pleural cavity volume and output was observed.
• One patient developed an additional esophageal-pleural fistula.

Conclusions:

• Atrial Septal Defect occluders represent a viable and effective treatment for bronchial fistulas.
• This method offers a less invasive alternative, leading to improved clinical outcomes and reduced pleural space complications.