Current Thoracic Surgery
2016 , Vol 1 , Issue 1
Bronchoscopic management of bronchopleural fistula
1Department of Thoracic Surgery, St. Vincentus Kliniken, Germany
DOI :
10.26663/cts.2016.0009
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Bronchopleural fistula (BPF) represents a pathological communication between any part of bronchial
tree and the pleural space. Mostly it is a rare yet serious complication of different pulmonary conditions
like certain infections, trauma, malignancy and/or surgery, going along with significant mortality
reported to be as high as 58%. Diagnosis of BPF is mostly done by evaluating these three data: clinical
appearance, bronchoscopy and CT scan. The treatment of BPF may initially differ according to the time
of appearance as well as clinical presentation. As most BPF goes along with empyema, it is, obviously,
necessary to deal with it. This is most commonly achieved with a chest tube. Conservative management
of BPF can be achieved using a significant variety of materials and methods with reportedly moderate
to excellent results in the treatment of etiologically and sizably different BPF. Methyl-2-cyanoacrylate,
fibrin sealant together with spongy calf bone, polidocanol - hydroxypolyethoxidodecane, amplatzer
device, silver nitrate, stenting and endobronchial valves have all been employed in bronchoscopic
treatment of a BPF. There is no evidence based guideline for its management, either surgically or
endoscopically. The treatment of choice is always in the hands of the physician, preferably armed with
the current knowledge and capacity of utilizing it.
Keywords :
Bronchopleural fistula; bronchial fistula; bronchoscopy; pleural disease; empyema; surgery