Shanghai Changhai Hospital, Shanghai, China
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Pulmonary Procedures
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Saturday, April 16, 2016 at 09:45 AM - 11:15 AM
PURPOSE: Bronchopleural Fistula (BPF) is a rare but severe complication with high morbidity and mortality. Multiple bronchoscopic managements have been applied to treat it. In this study, we retrospectively analyzed the clinical data from patients with BPF using endoscopic managements to compare multiple bronchoscopic therapies and suggest how to choose the appropriate bronchoscopic therapy for BPF.
METHODS: From January 2008 to December 2012, 23 patients with BPF treated in bronchoscopy center of Changhai Hospital were investigated. Their clinical data were collected and analyzed, including their demographic information, etiologies, radiologic and bronchoscopic findings, bronchoscopic treatments and prognosis.
RESULTS: All the 23 patients have received therapeutic bronchoscopy with 13 cases cured (56.5%), 6 cases effective (26.1%) and 4 cases invalid (17.4%). The cure rate for the 7 cases of peripheral BPF was 100%. Of the16 cases with central BPF, 6 out of the 9 cases charactered by fistula diameter≤3mm were cured (66.7%) and 3 were effective (33.3%). And 3 among the 7 patients charactered by fistula diameter＞3mm were improved (42.9%) but the other 4 were invalid (57.1%). During the treatment, 3 patients had fibrin sealant displacement, 2 had the stent displacement and 1 had the plug displacement. All of them got better after the endoscopic therapy. No severe life-threatening complications occured.
CONCLUSIONS: Bronchoscopy interventional therapy for BPF is safe and effective, especially for peripheral BPF and central type with fistula ≤ 3mm. And the treatment should be individualized followed the simple protocol proposed in this article.
CLINICAL IMPLICATIONS: Because of the complexity of BPF in pathogenesis and the individual difference of patients, the combination therapy provided significantly better outcomes than a single treatment. Combination of different kinds of devices in the bronchoscopic therapy can improve the cure rate and need a standard protocool.
DISCLOSURE: The following authors have nothing to disclose: Wei Zhang, Meng Yang, Yuchao Dong, Haidong Huang, Qin Wang, Qinying Sun, Yan Shang, Yi Huang, Chong Bai, Qiang Li
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