title: [Is endoscopic treatment of bronchopleural fistula useful?].
abstract: OBJECTIVE
  New endoscopic techniques have been developed as an alternative to surgical treatment of bronchopleural fistula. The objective of this study was to analyze our experience with endoscopic treatment of such fistulas.
  
  
  METHODS
  We conducted a retrospective study of patients with bronchopleural fistula diagnosed by fiberoptic bronchoscopy. Patient characteristics, underlying disease, fistula size, and outcome of endoscopic treatment were analyzed. The endoscopic technique consisted of injection of fibrin sealants (Histoacryl and/or Tissucol) through the catheter of the fiberoptic bronchoscope.
  
  
  RESULTS
  Between 1997 and 2004, 18 patients were diagnosed with bronchopleural fistula by fiberoptic bronchoscopy. All were men with a mean (SD) age of 62 (12) years. Bronchopleural fistula was diagnosed after neoplastic surgery in 16 patients, in the bronchial suture after lung transplantation in 1 patient, and concurrently with pleural effusion due to hydatidosis in the remaining patient. The size of the fistula ranged from 1 mm to 10 mm (mean 3.6 [2.7] mm). Fibrin sealants were applied in 14 patients, 2 underwent direct surgery after diagnosis, and the bronchopleural fistula closed spontaneously in the remaining 2. The fibrin sealant used was Histoacryl in 12 patients and Tissucol in 2. Pleural drainage was employed simultaneously and antibiotic therapy was administered at the discretion of the surgeon. The 4 patients whose bronchopleural fistula was associated with empyema also underwent pleural lavage. In 12 patients the fistulas closed as a result of the endoscopic technique (85.7%), and no complications were observed. For 85.7%, fewer than 3 applications of fibrin sealant were necessary.
  
  
  CONCLUSIONS
  The success rate of closure of bronchopleural fistula with fibrin sealants injected under guidance with fiberoptic bronchoscopy is high and there are no complications. This technique can render surgery unnecessary.
authors.affiliation: Servicio de Neumología, Hospital Universitario Puerta de Hierro, Madrid, España. gemora24@hotmail.com
authors.forename: Gemma
authors.initials: G
authors.lastname: Mora
authors.forename: Alicia
authors.initials: A
authors.lastname: de Pablo
authors.forename: Cristina L
authors.initials: CL
authors.lastname: García-Gallo
authors.forename: Rosalía
authors.initials: R
authors.lastname: Laporta
authors.forename: Piedad
authors.initials: P
authors.lastname: Ussetti
authors.forename: Pablo
authors.initials: P
authors.lastname: Gámez
authors.forename: Mar
authors.initials: M
authors.lastname: Córdoba
authors.forename: Andrés
authors.initials: A
authors.lastname: Varela
authors.forename: María J
authors.initials: MJ
authors.lastname: Ferreiro
mesh_terms: D001983:Bronchial Fistula / Q000628:therapy*; D001999:Bronchoscopy; D004659:Enbucrilate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D016156:Respiratory Tract Fistula / Q000628:therapy*; D012189:Retrospective Studies; D014014:Tissue Adhesives
chemical_list: D014014:Tissue Adhesives; D004659:Enbucrilate