Current Thoracic Surgery 2023 , Vol 8 , Issue 3
Postpneumonectomy bronchopleural fistula: cohort of patients in a Pevurian National Hospital
Karin Gonzales-Peña1,W Samir Cubas2,Pamela Villanueva-Zúñiga3
1Service of Thorax and Cardiovascular Surgery, Hipolito Unánue National Hospital, Lima, Peru
2Department of Thoracic and Cardiovascular Surgery, Edgardo Rebagliati Martins National Hospital, Lima, Peru
3Postgraduate Area, School of Medicine, Universidad San Martín de Porres, Lima, Peru
DOI : 10.26663/cts.2023.0024 Viewed : 1269 - Downloaded : 450 Background: Bronchopleural fistula (BPF) is a complication with a great impact on morbidity, mortality and survival in postoperative pneumonectomy patients. Our study aimed to determine the associated clinical-surgical characteristics of the BPF in a Peruvian cohort of patients with BPF following pneumonectomy.

Materials and Methods: Cross-sectional, and retrospective study during January 2015-June 2020 in a Peruvian National Hospital. Medical records and operative reports were reviewed, and all patients over age (>18 years) and with all-cause pneumonectomy were considered. The variables were grouped into pneumonectomies with and without BPF, and the characteristics were grouped as a baseline, clinicalsurgical and postoperative.

Results: Among fifty-seven patients who underwent pneumonectomy, 28% presented BPF. The mean age was 38.3 ± 15 years, and 62.5% were male. The main pathologies associated with BPF were posttuberculosis fibrocavitary sequelae (62.5%), pulmonary hydatidosis (18.8%), and post-surgical cavitary sequelae (12.5%). 81.3% were left BPF (p = 0.342) and 100% were related to postoperative empyema (p < 0.05). The mortality associated with BPF was 6.25%, and in the non-BPF group it was 4.87% (p = 0.098). Characteristics that were statistically associated with the presence of bronchopleural fistula were low predicted forced expiratory volume (FEV1) (56.3% vs. 31.7%; p = 0.046), preoperative empyema (37.5% vs. 2.4%; p = 0.001), postoperative empyema (100% vs. 9.8%; p = 0.000) and operative time (450.69 min vs. 367.73 min; p = 0.032).

Conclusions: There are a series of factors associated with the presence of patients with BPF following pneumonectomy, many of them mainly related to operative and postoperative events, which is an important predictor of associated complications in our Peruvian population. Keywords : bronchopleural fistula; pneumonectomy; empyema; tuberculosis; complication