title: Analysis of risk factors for postpneumonectomy bronchopleural fistulas in patients with lung cancer.
abstract: BACKGROUND
  Bronchopleural fistula is a potentially fatal complication of pulmonary resections, especially pneumonectomy.
  
  
  METHODS
  Univariate and multivariate analyses of the development of bronchopleural fistula were performed in 12 patients with bronchopleural fistula and 102 patients without bronchopleural fistula who had undergone pneumonectomy from January 1983 through December 2005.
  
  
  RESULTS
  Bronchopleural fistula developed after pneumonectomy in 12 patients (8.5%). Seven (58.7%) of the 12 patients died of bronchopleural fistula. Univariate analysis showed that preoperative infection, right pneumonectomy, and pathological N2, 3 disease significantly contributed to the development of postpneumonectomy bronchopleural fistula (p=0.0002, p=0.0043, and p=0.0387, respectively). Multivariate analysis also showed that preoperative infection, right pneumonectomy, and pathological N2, 3 disease were significant risk factors for postpneumonectomy bronchopleural fistula.
  
  
  CONCLUSIONS
  Bronchopleural fistula is strongly associated with preoperative infection, right pneumonectomy, and pathological N2, 3 disease. Bronchial stump coverage with pedicled tissue flaps and preservation of the bronchial arteries during mediastinal lymph node dissection are recommended to maintain the blood supply to the bronchial stump in patients at risk.
authors.affiliation: Department of Surgery, Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan. shuji@nms.ac.jp
authors.forename: Shuji
authors.initials: S
authors.lastname: Haraguchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Hioki
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hirata
authors.forename: Kyoji
authors.initials: K
authors.lastname: Hirai
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kubokura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007239:Infections / Q000150:complications; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010995:Pleural Diseases / Q000453:epidemiology / Q000209:etiology*; D011013:Pneumonectomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors