title: Endoscopic closure of bronchopleural fistula after pneumonectomy by submucosal injection of polidocanol.
abstract: We report two cases of a bronchopleural fistula with, and without, empyema treated by endoscopic submucosal injection of polidocanol (sclerotherapy) and application of cyanoacrylate. Case 1: A 60-year-old man underwent left pleuropneumonectomy for lung cancer. He developed bronchopleural fistula with empyema at 32 days after the operation. We performed sclerotherapy around the fistula. The air leakage stopped at 2 weeks after the sclerotherapy, and the fistula was closed. He was eventually cured of the empyema by pleural drainage. Case 2: A 61-year-old man underwent left pneumonectomy for lung cancer. He developed bronchopleural fistula without empyema at 50 days after the operation. We performed sclerotherapy and application of cyanoacrylate. After this therapy, the air leakage stopped immediately, and the bronchopleural fistula was closed. The sclerotherapy and application of cyanoacrylate are not only technically easy, but also very effective for treatment of bronchopleural fistula. Sclerotherapy and cyanoacrylate may be advocated as a first therapeutic step.
authors.affiliation: Department of Surgery 1, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Kanno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Koichi
authors.initials: K
authors.lastname: Fujiu
authors.forename: Akio
authors.initials: A
authors.lastname: Ohishi
authors.forename: Mitsukazu
authors.initials: M
authors.lastname: Gotoh
mesh_terms: D001983:Bronchial Fistula / Q000628:therapy*; D005402:Fistula / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D011013:Pneumonectomy; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000628:therapy*; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy; D013906:Thoracoscopy
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols