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Postoperative bronchopleural fistula repair: Surgical outcomes and adverse factors for its success

 Young Ho Yang  ;  Seong Yong Park  ;  Ha Eun Kim  ;  Byung Jo Park  ;  Chang Young Lee  ;  Jin Gu Lee  ;  Dae Joon Kim  ;  Hyo Chae Paik 
 THORACIC CANCER, Vol.13(9) : 1401-1405, 2022-05 
Journal Title
Issue Date
Bronchial Fistula* / etiology ; Bronchial Fistula* / surgery ; Humans ; Pleural Diseases* / etiology ; Pleural Diseases* / surgery ; Pneumonectomy / adverse effects ; Postoperative Complications / etiology ; Postoperative Complications / surgery ; Retrospective Studies ; Treatment Outcome
bronchopleural fistula ; lung transplant ; mechanical ventilation ; omental flap ; pulmonary resection
Background: The purpose of this study was to investigate the results of postoperative bronchopleural fistula repair and to identify adverse factors for its success.

Methods: We retrospectively reviewed the surgical results of 39 patients who underwent surgical repair for postoperative bronchopleural fistula between January 2010 and June 2020. Success of bronchopleural fistula repair was defined as the visual closure of the bronchopleural fistula with the absence of an air leak, a recurrence of bronchopleural fistula and infection in the thoracic cavity.

Results: Twenty-five (64.1%) bronchopleural fistulas occurred after pulmonary resection and 14 (35.9%) after lung transplantation. Bronchopleural fistula was diagnosed 19 days (median) and repaired 28 days (median) after the initial operation by primary closure in 27 (69.2%) patients, and by additional resection in 12 (30.8%) patients. The overall success rate was 59% (23/39) and the overall mortality was 56.4% (22/39). Multivariable analysis revealed that the patients who were supported by mechanical ventilation at the time of repair had significantly lower success rates than those without (15.4%, 2/13 vs. 80.8%, 21/26, respectively, p < 0.001). The omental flap group tended to have a better success rate than the muscle flap group (p = 0.07).

Conclusions: There was a high overall mortality rate after bronchopleural fistula repair and a low success rate. Mechanical ventilation at the time of bronchopleural fistula repair was significantly related to the failure of bronchopleural fistula repair.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Kim, Ha Eun(김하은)
Park, Byung Jo(박병조)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Yang, Young Ho(양영호)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
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