A.I. Burnasyan  FMBC clinical bulletin. 2023 № 3

G.A.Baksiyan, A.A.Zavialov

Bronchial Fistula is a Formidable and Insidious Complication in Oncological Practice

International Office, State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russiа

Contact person: Baksiyan Galust Aleksandrovich: galust_1983@mail.ru

Abstract
Bronchopleural fistula is one of the most dangerous complications in thoracic surgery and can occur both in the early postoperative period (especially in the first 7-10 days after surgical treatment) and many years after surgery. In most cases, the appearance of a bronchial fistula is associated with the progression of the oncological process, post-radiation changes in the bronchus stump, and also with a persistent pulmonary infection. The incidence of bronchus suture failure after pneumonectomy for non-small cell lung cancer is 1.5-12.5%, after lobectomy – 1-4%. Among the predictors of the development of this complication, there are: male sex, age over 65 years, patients with severe (ASA 3 or higher) and numerous concomitant diseases, right-sided and extended operations, combined antitumor treatment. A special role in the prevention of the development of bronchopleural fistula is given to surgical techniques for covering the bronchus stump with various tissues, mainly the pleura or muscles. The treatment of bronchial fistula involves the relief of the general inflammatory reaction, the sanitation of the residual pleural cavity and the direct closure of the defect, using various options for broncho- and thoracoplasty.

Keywords: bronchopleural fistula, bronchus fistula, bronchus suture failure, residual pleural cavity, chronic pleural empyema, bronchoplasty, thoracoplasty

For citation: Baksiyan GA, Zavialov AA. Bronchial Fistula is a Formidable and Insidious Complication in Oncological Practice. A.I. Burnasyan Federal Medical Biophysical Center Clinical Bulletin. 2023.3:41-46. (In Russian) DOI: 10.33266/2782-6430-2023-3-41-46

 

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Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship. 
Contribution. Article was prepared with equal participation of the authors.
Article received: 10.06.2023. Accepted for publication: 12.07.2023