Treatment Of Postoperative Bronchopleural Fistula By The Trachea Interventional Therapy Of Metal Fully Covered Self-expandable Stent

BackgroundBPF is a common complication after pulmonary lobectomy. It is reported that the incidence rate of BPF after pneumonectomy was about3%to28%; while after pulmonary lobectomy was about0.5%, and its overall mortality could reach from16%to72%. After many patients confirmed diagnosis, they could not tolerate thoracotomy again as their general condition is poor, so they can only choose conservative treatment. A lot of scholars tried to block fistula by bronchoscopy treatment(fibronectin glue,demineralized human donor spongiosa, sclerosing agent, etc.), but these methods did not have a good curative effect when the fistula size exceeds3mm. There were also several scholars treating BPF by using airway stent, and achieved some curative effects.ObjectiveThe purpose of this study was to assess the feasibility, efficacy and safety of the use of a coverd self-expandable metal stent for the treatment of PPBPF.Methods5cases of PPBPF patients were collected from October2012to April2014.Discuss and analyze its clinical characteristics、imaging manifestations、endoscopic stent treatment et al, and review combining with relevant literature.ResultsFour of five cases are successfully implanted airway stents,the case4whose stent fall into the right side of the chest, then we use medical thoracoscopy to take out the stent and placement successfully with bronchoscopy.The fistulas were successful closure, no intraoperative and postoperative complications.Due to a serious lung infection,case1was automatic discharge. All patient at a mean follow-up time of13months(range1-23months), all stents were not removed.Conclusions1.Airway covered stent is easy to insert and stent related complication rate was low.2.The application of the airway coverd stent is a safe and effective method to treat the postpneumectomic brochopleural fistula.