Clinical Characteristics Of Bronchopleural Fistula In Patients With Lungcancer Treated With Neoadjuvant Therapy

Purpose:To explore the risk factors of bronchopleural fistula by retrospectively analyzing the general clinical information,operation related information and histopathological results of lung cancer patients with bronchopleural fistula after neoadjuvant treatment.Data and methods:The clinical data of 36 patients with lung cancer who received preoperative neoadjuvant treatment in the chest tumor diagnosis and treatment center of Bethune First Hospital Affiliated to Jilin University from September 2019 to December 2021 were collected.According to the occurrence of bronchopleural fistula,the patients were divided into preoperative neoadjuvant treatment group without bronchopleural fistula and preoperative neoadjuvant treatment group with bronchopleural fistula.The database was established based on the general clinical information,operation related information and histopathological results of patients,and the related clinical characteristics of postoperative bronchopleural fistula in lung cancer patients treated with neoadjuvant therapy before operation were compared and analyzed by prism 8.0 software.Using unpaired t-test and Fisher’s accurate test,P < 0.05 indicates that there is a statistical difference.result:This study statistically analyzed the relevant clinical data of 36 patients with lung cancer who successfully received thoracoscopic minimally invasive surgery after preoperative neoadjuvant treatment.There were 30 patients in the group without bronchopleural fistula after preoperative neoadjuvant treatment and 6 patients in the group with bronchopleural fistula after preoperative neoadjuvant treatment.The specific comparison results are as follows:（1）general clinical information: there was no significant difference in gender and age between the two groups（P > 0.05）,and there was no significant difference in smoking history between the two groups（P > 0.05）.（2）Operation related information: according to the location of the cancer,there was no significant difference between the left and right groups in the location of the focus and whether there was bronchopleural fistula（P = 0.2100）;For the resection range,there was significant difference between the range greater than a single lobe and the range less than or equal to a single lobe（P < 0.05）;According to the pathological nature of the cutting edge,no cancer tissue and cancer cells were found in the cutting edge of all patients,so there was no significant difference between the two groups;There was significant difference between the group of tumor invasion area before neoadjuvant treatment and the group of non cancer invasion area before neoadjuvant treatment（P < 0.05）.（3）Histopathological results: according to the pathological nature of puncture before neoadjuvant therapy,the pathological result of preoperative puncture was squamous cell carcinoma or adenocarcinoma,and there was no significant difference between patients with preoperative neoadjuvant therapy and patients with postoperative bronchopleural fistula（P > 0.9999）;There was no significant difference between the postoperative pathological results and the postoperative bronchopleural fistula after neoadjuvant treatment（P = 0.3781）.Conclusion:1)The occurrence of bronchopleural fistula in patients with lung cancer who received neoadjuvant therapy before operation had nothing to do with age,gender and smoking history,and no significant statistical difference was found.2)The occurrence of bronchopleural fistula in patients with lung cancer who received neoadjuvant treatment before operation is not related to the location of lung cancer,but related to the size of operation and whether the cutting edge is the area of cancer invasion before neoadjuvant treatment.Larger operations with a larger resection range than a single lung lobe are more prone to postoperative bronchopleural fistula.If the surgical margin is the area of cancer invasion before neoadjuvant therapy,the possibility of postoperative bronchopleural fistula will increase.As for the factor of incision margin pathology,because the surgery of the study patients has achieved radical resection effect,its influence has not been found.3)The occurrence of bronchopleural fistula in patients with lung cancer who received neoadjuvant therapy before operation has nothing to do with the pathological type of cancer and the effect of this neoadjuvant therapy（chemotherapy plus immunotherapy）.