The Amplatzer device and pedicle muscle flap transposition for the treatment of bronchopleural fistula with chronic empyema after lobectomy: two case reports
Open Access
- 26 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in World Journal of Surgical Oncology
- Vol. 19 (1), 1-7
- https://doi.org/10.1186/s12957-021-02270-x
Abstract
Bronchopleural fistula (BPF) refers to an abnormal channel between the pleural space and the bronchial tree. It is a potentially fatal postoperative complication after pulmonary resection and a complex challenge for thoracic surgeons because many patients with BPF ultimately develop refractory empyema, which is difficult to manage and has a major impact on quality of life and survival. Therefore, an operative intervention combined with conservative and endoscopic therapies may be required to control infection completely, to occlude BPF, and to obliterate the empyema cavity during treatment periods. Two patients who suffered from BPF complicated with chronic empyema after lobectomy were treated in other hospitals for a long time and did not recover. In our department, we performed staged surgery and creatively combined an Amplatzer Septal Occluder (ASO) device (AGA Medical Corp, Golden Valley, MN, USA) with pedicled muscle flap transposition. First, open-window thoracostomy (OWT), or effective drainage, was performed according to the degree of contamination in the empyema cavity after the local infection was controlled. Second, Amplatzer device implantation and pedicled muscle flap transposition was performed at the same time, which achieved the purpose of obliterating the infection, closing the fistula, and tamponading the residual cavity. The patients recovered without complications and were discharged with short hospitalization stays. We believe that the union of the Amplatzer device and pedicle muscle flap transposition seems to be a safe and effective treatment for BPF with chronic empyema and can shorten the length of the related hospital stay.Keywords
Funding Information
- Basic Public Welfare Research Program of Zhejiang Province (GF21H020010)
- Clinical Research Fund of Zhejiang Medical Association (2020ZYC-A03)
This publication has 17 references indexed in Scilit:
- Customized airway stenting for bronchopleural fistula after pulmonary resection by interventional technique: single-center study of 148 consecutive patientsSurgical Endoscopy, 2018
- Pedicle muscle flap transposition for chronic empyema with persistent bronchopleural fistula: experience of a single clinical center in ChinaSurgery Today, 2016
- Endobronchial closure of bronchopleural fistula using Amplatzer device2015
- The Rationale for Treatment of Postresectional Bronchopleural Fistula: Analysis of 52 PatientsThe Annals of Thoracic Surgery, 2015
- Intrathoracic Muscular Transposition in Chronic Tuberculous EmpyemaThe Thoracic and Cardiovascular Surgeon, 2012
- Endobronchial Closure of Bronchopleural Fistulae Using Amplatzer DevicesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2011
- Management of Postpneumonectomy Empyema Using Free Flap and Pedicled FlapThe Annals of Thoracic Surgery, 2010
- Single-Stage Muscle Flap Reconstruction of the Postpneumonectomy Empyema Space: The Emory ExperiencePlastic and Reconstructive Surgery, 2007
- Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management.2001
- Bronchopleural fistulas associated with lung cancer operations. Univariate and multivariate analysis of risk factors, management, and outcome.1992