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Anastomotic Airway Complications after Lung Transplantation

 Eun Na Cho  ;  Suk Jin Haam  ;  Song Yee Kim  ;  Yoon Soo Chang  ;  Hyo Chae Paik 
 YONSEI MEDICAL JOURNAL, Vol.56(5) : 1372-1378, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Analysis of Variance ; Anastomosis, Surgical/adverse effects* ; Anastomosis, Surgical/methods ; Bronchi/blood supply ; Bronchi/physiopathology ; Bronchi/surgery* ; Bronchial Diseases/epidemiology ; Bronchial Diseases/etiology* ; Bronchial Diseases/physiopathology ; Bronchoscopy ; Female ; Humans ; Incidence ; Lung Transplantation* ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology* ; Postoperative Complications/physiopathology ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Treatment Outcome
Lung transplantation ; postoperative complications ; surgical anastomosis
PURPOSE: Anastomotic airway complications are a major cause of morbidity and mortality after lung transplantation (LTx). In this study, the authors identified types and clinical outcomes of airway complications after LTx. MATERIALS AND METHODS: All bronchial anastomotic complications were analyzed in a total of 94 LTx cases involving 90 recipients who underwent surgery between July 2006 and May 2014. Fifteen LTx cases (14 recipients) with incomplete medical records for fiberoptic bronchoscopy (FBS) and three cases underwent heart-lung transplantation (HLT) were excluded. Postoperative FBS at 24-48 hours, 1, 3, 6, and 12 months, and then yearly after the transplantation were performed. RESULTS: A total of 76 LTx cases (75 recipients) were analyzed. The mean age of the recipients was 49.55 years (range, 18-71 years), and 38 (49.4%) were male. Twenty-one out of 76 cases (27.6%) experienced early anastomotic complications, and 12 (15.8%) presented late anastomotic complications. The early anastomotic airway complications presented in various forms: stenosis, 1 case; narrowing, 1; necrosis & dehiscence, 3; fistula, 4; granulation, 10; and infection, 2. Late complications almost entirely presented in the form of bronchial stenosis; five recipients showed stenosis at the anastomosis site, and one of them showed improvement after ballooning. Five others were found to have stenosis at the bronchus intermedius, distal to the anastomosis site. Three of these patients showed improvement after ballooning or bronchoplasty. CONCLUSION: By serial surveillance via FBS after LTx, we detected anastomotic airway complications in 42.9% of cases, which were successfully managed with improved clinical outcomes.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
Cho, Eun Na(조은나)
Haam, Seok Jin(함석진)
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