HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sonobe, M. Articles by Shindo, T. Search for Related Content PubMed PubMed Citation Articles by Sonobe, M. Articles by Shindo, T.

Eur J Cardiothorac Surg 2000;18:519-523
© 2000 Elsevier Science NL

Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung cancer

Department of Thoracic Surgery, Tenri Hospital, Mishima-cho 200, Tenri City, Nara 632-8552, Japan

Received 11 February 2000; received in revised form 23 June 2000; accepted 18 July 2000.

Corresponding author. Tel.: +81-743-63-5611; fax: +81-743-62-5576
e-mail: mysonobe{at}d5.dion.ne.jp

Objectives: Despite the advances in surgical technology, bronchopleural fistulas (BPFs) still occur and are often fatal. We studied the risk factors for BPF formation after lung cancer operation to clarify the indication of preventive bronchial stump coverage. In addition, the reliability of our methods of bronchial closure was evaluated. Methods: We reviewed 557 consecutive bronchial stumps, corresponding to 547 patients without any coverage in pulmonary resection for lung cancer between 1989 and 1998. According to nine variables, stumps that made dehiscence were compared with uneventful ones using contingency table analysis. The incidence of BPFs according to each method of bronchial closure was calculated. Results: BPFs developed in ten patients (1.8%). Compared with the lobar bronchus (LB), the main bronchus (MB; P<0.01; odds ratio, 23.0) and the intermediate bronchus (IB; P=0.03; odds ratio, 10.7) carried a high risk. Previous ipsilateral thoracotomy (P<0.01; odds ratio, 37.9) and preoperative chemotherapy and/or radiotherapy (P=0.02; odds ratio, 13.2) increased the risk. The incidence of BPFs with manual suture, stapling devices only, reinforcement suture at the distal side of staplers, or reinforcement suture at the proximal side of staplers was 1.8, 5.0, 1.9 and 1.0%, respectively. Conclusions: The main and intermediate bronchial stumps, and the stumps in cases with previous ipsilateral thoracotomy or receiving induction therapy are prone to BPFs. Preventive coverage should be considered for these stumps. Our methods for reinforcement of stapled stumps are thought to be reliable.

Key Words: Lung cancer • Surgery • Complication • Bronchopleural fistula

This article has been cited by other articles:

				M. R. Kramer, N. Peled, D. Shitrit, E. Atar, M. Saute, D. Shlomi, A. Amital, and E. Bruckheimer Use of Amplatzer Device for Endobronchial Closure of Bronchopleural Fistulas Chest, June 1, 2008; 133(6): 1481 - 1484. [Abstract] [Full Text] [PDF]

				P. A. Kvale, P. A. Selecky, and U. B. S. Prakash Palliative Care in Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 368S - 403S. [Abstract] [Full Text] [PDF]

				I. Nagahiro, M. Aoe, Y. Sano, H. Date, A. Andou, and N. Shimizu Bronchopleural Fistula After Lobectomy for Lung Cancer Asian Cardiovasc Thorac Ann, February 1, 2007; 15(1): 45 - 48. [Abstract] [Full Text] [PDF]

				C.-C. Chang, H.-H. Hsu, S.-W. Kuo, and Y.-C. Lee Bronchoscopic gluing for post-lung-transplant bronchopleural fistula Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 328 - 330. [Abstract] [Full Text] [PDF]

				T. Maniwa, Y. Saito, H. Kaneda, and H. Imamura Bronchial stump reinforcement with the intercostal muscle flap without adverse effects. Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 652 - 656. [Abstract] [Full Text] [PDF]

				Y. Satoh, S. Okumura, K. Nakagawa, A. Horiike, F. Ohyanagi, M. Nishio, T. Horai, and Y. Ishikawa Postoperative ischemic change in bronchial stumps after primary lung cancer resection. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 172 - 176. [Abstract] [Full Text] [PDF]

				D. Feller-Kopman, R. Bechara, R. Garland, A. Ernst, and S. Ashiku Use of a removable endobronchial valve for the treatment of bronchopleural fistula. Chest, July 1, 2006; 130(1): 273 - 275. [Abstract] [Full Text] [PDF]

				M. Lois and M. Noppen Bronchopleural Fistulas: An Overview of the Problem With Special Focus on Endoscopic Management Chest, December 1, 2005; 128(6): 3955 - 3965. [Abstract] [Full Text] [PDF]

				G. E. Darling, A. Abdurahman, Q.-L. Yi, M. Johnston, T. K. Waddell, A. Pierre, S. Keshavjee, and R. Ginsberg Risk of a Right Pneumonectomy: Role of Bronchopleural Fistula Ann. Thorac. Surg., February 1, 2005; 79(2): 433 - 437. [Abstract] [Full Text] [PDF]

				R. Bazzocchi, A. Bini, M. Grazia, and F. Petrella Bronchopleural fistula prevention after major pulmonary resection for primary lung cancer Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 160 - 160. [Full Text] [PDF]