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Bronchopleural fistula. Thirteen-year experience with 77 cases
The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1978
Summary
Bronchopleural fistula is a serious complication of lung disease and surgery. Myoplasty with thoracoplasty offers the highest success rate for treating this condition, with significantly lower mortality.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Complications
Background:
- Bronchopleural fistula (BPF) remains a grave complication of pulmonary disease and surgery.
- Despite reduced incidence, BPF carries significant morbidity and mortality.
- Prevention is crucial, with key factors including careful patient selection and surgical technique.
Purpose of the Study:
- To evaluate the effectiveness of different surgical treatments for bronchopleural fistula.
- To identify optimal strategies for fistula obliteration and patient survival.
Main Methods:
- Retrospective analysis of 77 patients treated for bronchopleural fistula over 13 years.
- Comparison of outcomes for conservative management versus various surgical interventions.
- Detailed assessment of surgical techniques including drainage, bronchial stump resuture, thoracoplasty, and myoplasty.
Main Results:
- Only 57.1% of patients were cured of BPF, with a 19.5% mortality rate.
- Conservative treatment failed in all six patients.
- Surgical intervention was necessary for 71 patients, requiring 133 operations.
- Myoplasty, often combined with thoracoplasty, demonstrated the highest closure rate (80%) and lowest mortality (5%) among treated patients.
Conclusions:
- Surgical intervention is essential for treating bronchopleural fistula.
- Myoplasty, particularly when combined with thoracoplasty, represents the most effective treatment strategy.
- Emphasis on preventative measures is vital to reduce the incidence of BPF.