Endoscopic treatment of bronchopleural fistulas.
BACKGROUND
Bronchial fistula is one of the most serious complications of pulmonary resection.


METHODS
We present an endoscopic treatment that consists of multiple submucosal injections of polidocanol-hydroxypoliethoxidodecane (Aethoxysklerol Kreussler) on the margins of the fistula using an endoscopic needle inserted through a flexible bronchoscope.


RESULTS
From 1984 to 1995, 35 consecutive nonselected patients with a postresectional bronchopleural fistula were treated. All 23 partial postpneumonectomy or postlobectomy bronchopleural fistulas, ranging from 2 to 10 mm in diameter, healed completely. This did not occur in the 12 total bronchial dehiscences. No complications occurred due to the injection of the drug.


CONCLUSIONS
In our opinion this treatment can be considered a valid therapeutic approach, as it is simple, safe, scarcely traumatic, and inexpensive, particularly considering that, in patients in stable condition, it can be performed as an outpatient treatment.
Varoli
F
F
Department of Surgery, University of Milan, San Giuseppe Hospital, Italy.
Roviaro
G
G
Grignani
F
F
Vergani
C
C
Maciocco
M
M
Rebuffat
C
C
D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D001999:Bronchoscopy; D004724:Endoscopy / Q000379:methods*; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007267:Injections; D008175:Lung Neoplasms / Q000601:surgery; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D011013:Pneumonectomy; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011183:Postoperative Complications; D013529:Surgical Wound Dehiscence; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome
D014014:Tissue Adhesives; D000077423:Polidocanol; D011092:Polyethylene Glycols