Endoscopic stenting for double bronco-pleural fistula after lobectomy.
Bronchial fistula is one of the most serious complications after pulmonary resection. It presents a challenge in terms of treatment, with a high risk of perioperative mortality. We describe a patient who underwent a right upper lobectomy and systematic hilar-mediastinal lymphadenectomy for lung adenocarcinoma complicated by 2 bronchopleural fistulas. The lesions were sited at the upper lobar stump and the pars membranacea of the intermediate bronchus. The patient was successfully treated by placement of an endobronchial prosthesis (initially a self-expanding prosthesis and subsequently, a Dumon prosthesis) and a pleural chest drain, to avoid a potential right pneumonectomy.
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy giacomare55@hotmail.com.
Giacomo
G
Cusumano
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy.
Alberto
A
Terminella
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy.
Ignazio
I
Vasta
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy.
Carmelo
C
Riscica Lizzio
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy.
Salvatore
S
Bellofiore
Division of General Thoracic Surgery, Vittorio Emanuele Policlinico Hospital, Catania, Italy.
Salvatore
S
Saita
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy / Q000295:instrumentation*; D004322:Drainage; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011013:Pneumonectomy / Q000009:adverse effects*; D011474:Prosthesis Design; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Bronchoscopy; empyema; pleural; pneumonectomy; postoperative complications; respiratory tract fistula; stents