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Broncho pleural fistula

Jeannine Blatter, Thorsten Krueger, Hans-Beat Ris, Moira Baeriswyl, Alban Lovis, Mathieu Zellweger, Michel Gonzalez, Jean Yannis Perentes
BACKGROUND: Extrathoracic muscle flaps can be used as airway substitutes for the closure of complex bronchopleural or tracheoesophageal fistulas or in the context of tracheocarinal reconstructions after resection for centrally localized tumors in order to alleviate excess anastomotic tension. METHODS: Evaluation of all patients undergoing tracheocarinal reconstructions with extrathoracic muscle flap patches as airway substitutes in our institution from 1996 to 2016...
May 2018: Annals of Thoracic Surgery
Domenico Galetta, Lorenzo Spaggiari
BACKGROUND: The role of induction therapy (IT) and its effects on morbidity and mortality of patients receiving tracheal sleeve pneumonectomy (TSP) are unclear. We evaluated early and long-term outcomes of patients who underwent TSP after IT. METHODS: From 1998 to 2015, 32 patients (26 men; median age, 63 years) underwent TSP. Twenty-two patients (69%) received IT (cisplatin-based chemotherapy). The TSPs were all right sided and included three completion pneumonectomies...
April 2018: Annals of Thoracic Surgery
Jean-Baptiste Stern, Ludovic Fournel, Benjamin Wyplosz, Philippe Girard, Malik Al Nakib, Dominique Gossot, Agathe Seguin-Givelet
INTRODUCTION: Post-pneumonectomy empyema (PPE) is the most severe complication of pneumonectomy. Microbiology and its impact on management and prognosis have rarely been reported METHODS: We retrospectively reviewed the files of a series of 37 consecutive patients with PPE over a 10-year period with a special focus on microbiology, means used to treat empyema and prognosis. RESULTS: PPE occurred within 14 days of pneumonectomy in 17 cases (early PPE) and after postoperative day 16 in 20 patients (delayed PPE)...
November 8, 2017: Clinical Respiratory Journal
Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari
We evaluated principal risk factors and different therapeutic approaches for post-pneumonectomy bronchopleural fistula (BPF), focusing on open-window thoracostomy (OWT). We retrospectively reviewed all patients treated by pneumonectomy for lung cancer from 1999 to 2014; we evaluated preoperative, operative, and postoperative data; time between operation; and fistula formation, size, treatment, and predicting factors of BPF. Cumulative incidence curves for the development of BPF were drawn according to the Kaplan-Meier method...
November 3, 2017: Seminars in Thoracic and Cardiovascular Surgery
Johns Shaji Mathew, K Manikandan, K Y Santosh Kumar, S T Binoj, Dinesh Balakrishnan, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, O V Sudheer, S Aneesh, Surendran Sudhindran
INTRODUCTION: In live donor liver transplantation (LDLT), bile duct division is a critical step in donor hepatectomy. Biliary complications hence are a feared sequelae even among donors. Long term data on biliary complications in donors from India are sparse. METHODS: Prospective evaluation of 452 live donors over 10 years was performed to ascertain the incidence & risk factors of clinically significant biliary complications. RESULTS: Of the 452 donor hepatectomies (M: F = 114:338, median age = 38), 66...
October 19, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Terunaga Inage, Takahiro Nakajima, Taiki Fujiwara, Kentaro Murakami, Masaya Uesato, Hisahiro Matsubara, Ichiro Yoshino
Anastomotic failure of a gastric tube inserted for reconstruction following esophagectomy, which is relatively rare, causes pleural infection and persistent pleural irritation, leading to communication with the pulmonary parenchyma. Although several interventions have been reported to treat such broncho-gastric tube fistulas, refractory cases remain. We herein report the successful treatment by endoscopic bronchial occlusion with an endobronchial Watanabe spigot in 2 patients who suffered from the above complication...
2017: Respiration; International Review of Thoracic Diseases
Leonardo Duranti, Luca Tavecchio, Giovanni Leuzzi, Ugo Pastorino
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
Sang Gi Oh, Yochun Jung, Sanghoon Jheon, Yunhee Choi, Ju Sik Yun, Kook Joo Na, Byoung Hee Ahn
BACKGROUND: Results of studies to predict prolonged air leak (PAL; air leak longer than 5 days) after pulmonary lobectomy have been inconsistent and are of limited use. We developed a new scale representing the amount of early postoperative air leak and determined its correlation with air leak duration and its potential as a predictor of PAL. METHODS: We grade postoperative air leak using a 5-grade scale. All 779 lobectomies from January 2005 to December 2009 with available medical records were reviewed retrospectively...
January 23, 2017: Journal of Cardiothoracic Surgery
Fadil Gradica, Lutfi Lisha, Dhimitraq Argjri, Cani Alma, Fahri Kokici, Flora Gradica, Valbona Rexha, Sali Gradica, Donika Ahmati, Perlat Kapisyzi
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Oncology
Leonardo Duranti, Luca Tavecchio, Giovanni Leuzzi, Ugo Pastorino
We herein report a case of a 56-year old man who underwent an intrapericardial right pneumonectomy plus partial left atrial resection for a lung sarcomatoid carcinoma. One month after surgery, the patient developed a broncho-pleural fistula in the right main bronchus. After the failure of several consecutive conservative and surgical treatments (bronchoscopic submucosa injection of fibrin glue, thoracostomy, Amplatzer device placement, omentoplasty, VAC therapy), the patient developed a pleural empyema. So, we decided to fill the pleural space with granulated sugar (changing thoracostomy dressing daily) with subsequent clinical improvement, allowing a definitive surgical closure through a thoracoplasty...
July 1, 2016: European Journal of Cardio-thoracic Surgery
Naseem Salahuddin, Naila Baig-Ansari, Saulat Hasnain Fatimi
To our knowledge, this is an unusual case of a community-acquired pneumonia (CAP) with sepsis secondary to Streptococcus pneumoniae that required lung resection for a non-resolving consolidation. A 74 year old previously healthy woman, presented with acute fever, chills and pleuritic chest pain in Emergency Department (ED). A diagnosis of CAP was established with a Pneumonia Severity Index CURB-65 score of 5/5. In the ER, she was promptly and appropriately managed with antibiotics and aggressive supportive therapy...
June 2016: JPMA. the Journal of the Pakistan Medical Association
Takuma Tsukioka, Makoto Takahama, Ryu Nakajima, Michitaka Kimura, Hidetoshi Inoue, Ryoji Yamamoto
BACKGROUND: Pulmonary and left atrial resection is not yet an established treatment for patients with primary lung cancer involving the left atrium. We investigated the clinical course of patients with primary lung cancer involving the left atrium who were treated with pulmonary resection and partial atrial resection. METHODS: From January 1996 to December 2013, 51 patients underwent extended resection for lung cancer that invaded the surrounding organs. Of these, we focused on 12 patients who underwent surgical treatment for lung cancer involving the left atrium...
December 2016: International Journal of Clinical Oncology
Elaine Soon, Pasupathy Sivasothy
No abstract text is available yet for this article.
July 15, 2016: American Journal of Respiratory and Critical Care Medicine
Mohamed-Sadok Boudaya, Walid Abid, Mona Mlika
Sleeve resection is a valid option in the surgical treatment of lung tumors, avoiding large resection. To ensure a good functional result and avoid post-operative complications like recent broncho-pleural fistulas and long-term stenosis, anastomosis between bronchi must be well performed. We report two cases of sleeve resection of the right lower lobe and show how we managed caliber discrepancy between the middle lobe bronchus and the truncus intermedius.
February 2016: Indian Journal of Surgery
Dongsub Noh, Chang-Kwon Park
Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy...
April 2016: Korean Journal of Thoracic and Cardiovascular Surgery
E V Levchenko, S M Ergnian, V A Shutov, A S Barchuk
AIM: To evaluate results of circular resection and carina reconstruction in patients with bronchial cancer. MATERIAL AND METHODS: Study included 82 patients with bronchial malignant tumors operated for the period from 1998 to 2014. Mean age was 56±1.1 years (range 24-75). There were 75 men and 7 women. Squamous cell carcinoma, adenocarcinoma, dimorphic cancer, carcinoid, adenocystic cancer, small cell cancer and clear cell renal cancer were observed in 66, 9, 1, 3, 1, 1 and 1 patients respectively...
2016: Khirurgiia
Hyun Jung Yoon, Myung Jin Chung, Kyung Soo Lee, Jung Soo Kim, Hye Yun Park, Won-Jung Koh
OBJECTIVE: To determine the patho-mechanism of pleural effusion or hydropneumothorax in Mycobacterium avium complex (MAC) lung disease through the computed tomographic (CT) findings. MATERIALS AND METHODS: We retrospectively collected data from 5 patients who had pleural fluid samples that were culture-positive for MAC between January 2001 and December 2013. The clinical findings were investigated and the radiological findings on chest CT were reviewed by 2 radiologists...
March 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Mohsen Ibrahim, Fioralba Pindozzi, Cecilia Menna, Erino A Rendina
Diffuse tracheobronchial calcification is a physiological condition associated with advanced age, especially in women. A calcified bronchus can be fractured during major lung resections (lobectomy, bilobectomy, and pneumonectomy), exposing patients to intraoperative air leakage and broncho-pleural fistula (BPF) occurrence. We retrospectively evaluated the use of Progel® application on the suture line of bronchial stump after pulmonary lobectomy analysing the intraoperative air leak and BPF occurrence. Between January 2014 and December 2014, Progel® was applied in 11 patients who presented intraoperative bronchial fractures after suture resection by mechanical staplers and air leak from bronchial stump, in order to treat air leakage...
February 2016: Interactive Cardiovascular and Thoracic Surgery
Jiro Abe, Toru Hasumi, Satomi Takahashi, Ryota Tanaka, Taku Sato, Toshimasa Okazaki
A broncho-pulmonary artery fistula is one of the most fatal complications of lung cancer surgery. This article discusses the case of a patient who died of massive hemoptysis after a left upper lobectomy. There were no previous signs of broncho-pleural fistula except for an obstinate dry cough and slightly elevated serum C-reactive protein levels after surgery. An autopsy revealed that a fistula had formed between the bronchial stump and the pulmonary artery, leading to prolonged inflammation and ultimately a broncho-pulmonary artery fistula...
2015: Journal of Surgical Case Reports
Venkatraman S Bhat, Manjunath Poojaramuddanahalli, Natarajan Rajagopalan, Karthik Gadabanahalli
Spontaneous extension of air from the pleural space to the chest wall, also referred to as pneumothorax necessitans (PN), is a rare occurrence. Few of such cases have been reported in the literature, some appear to have a pattern of extension from pleural cavity to chest wall. Clinical conditions known to predispose to this complication are pneumothorax, empyema thoracis and tuberculosis of the pleural space or rib. We report a case of PN arising as complication of postpneumonectomy empyema (PPE) secondary to broncho-pleural fistula...
June 2015: Journal of Clinical and Diagnostic Research: JCDR
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