Ethanolamine Oleate for Bronchopleural Fistula: Case Series

Bronchopleural fistula (BPF) is a severe complication of pulmonary resection associated with high morbidity and mortality. Treatment options include both surgical and endoscopic procedures. The size of the fistula and the functional status of the patient are decisive factors in the choice of treatment. The aim of this study is to describe the experience of using ethanolamine oleate (EO) in endoscopic treatment for BPFs.

A prospective observational, descriptive study, involving patients with subcentimeter BPF and treated with EO. The diagnosis of the fistula was confirmed by flexible bronchoscopy. Patients under conscious sedation received a perifistular injection of EO with a Wang 22-G needle. The procedure was repeated every to 2 weeks until definitive closure.

Eight patients were included: in 7 (87.5%), the fistula was a complication of lung cancer surgery. The number of sessions needed before the resolution of the BPF was from 1 to 4. Only 1 patient received 4 sessions. Complete closure was obtained in 6 patients (75%). None of the fistulas reopened, and there were no serious complications.

Sclerosis with EO through endoscopic injection enables the closure of small (<1 cm) BPFs after a limited number of sessions and with scarce morbidity. These results suggest that EO could be a valid treatment option for selected patients.