Feasibility Analysis Of Atrial Septal Defect Occluder And Silicone Spigot In Bronchopleural Fistulas

Objective:To discuss the feasibility of atrial septal defect(ASD)occluder and Silicone spigot implantation technique in treating bronchopleural fistulas(BPFs).Methods:Clinical date of 5 patients with central BPFs treated with ASD occluder through bronchoscopy and 3 patients with peripheral BPFs treated with silicone spigot through bronchoscopy in our hospital from April 2018 to December 2019 were collected.And reviewed the relevant literature to evaluated the feasibility of ASD occluder and Silicone spigot implantation technique for BPFs.Results:A total of 5 ASD occluders were successfully implanted in 5 cases with central BPFs with single procedure.Five fistulas were instantly and totally blocked after the treatment.Three patients removed their thoracic drainage tubes 7-30 days after the procedure,and there was no recurrence of fistula after follow-up of 1-11 months.The fistula was enlarged 1month after the procedure in 1 patient,and the occluder was removed.The infection was aggravated after the thoracic drainage tube fell off on three days after the procedure in 1 patient,and the treatment was abandoned.A total of 6 silicone spigots were placed in 3 cases with peripheralBPFs.All target bronchi were instantly and totally blocked after the treatment.One of cases coughed up the silicone spigot 2 days after the procedure and re-inserted a silicone spigot.Three patients removed their thoracic drainage tubes 8-15 days after the procedure,and air leakage was stopped after follow-up of 1-10 months.Conclusion:1.ASD occluder is one of the effective treatment methods for central BPFs.2.Silicone spiot is one of the effective treatment methods for peripheral BPFs.