Factors Associated with Successful Closure of Postpneumonectomy Bronchopleural Fistula in Patients with Empyema in a Hospital in Lima, Peru
Main Article Content
Abstract
Objective: To evaluate the factors associated with the closure of the postpneumonectomy bronchopleural fistula in patients with empyema.
Methods: Analytical observational study in which 28 medical records of patients undergoing surgical management of post-pneumonectomy bronchopleural fistula (BPF) were evaluated.
Results: The mean age was 43 years ± 12, the male sex was the most frequent (85.7%). The association of the right BPF and failure to close showed a Chi2 of 6.25 (p= 0.01); and regarding the association of the length of the bronchial stump greater than or equal to 1.5 cm and the success in closing the BPF, a Chi2 of 9.17 was obtained (p= 0.002).
Conclusions: The type of surgical management, the length of the bronchial stump and the left location of the BPF were factors associated with successful closure of the postpneumonectomy BPF in this study.
Downloads
Article Details

This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Okuda M, Go T, Yokomise H. Risk factor of bronchopleural fistula after general thoracic surgery: review article. Gen Thorac Cardiovasc Surg 2017;65(12):679–85. Doi: 10.1007/s11748-017-0891-6.
Bribriesco A, Patterson GA. Management of Postpneumonectomy Bronchopleural Fistula. Thorac Surg Clin 2018;28(3):323–35. Doi: 10.1016/j.thorsurg.2018.04.004.
Sugarbaker DJ, Bueno R, Colson YL et al. Sugarbaker’s Adult Chest Surgery. 3rd ed. McGraw-Hill Education, 2020; pp. 340-357.
Wain JC. Management of late postpneumonectomy empyema and bronchopleural fistula. Chest Surg Clin N Am 1996;6(3):529–41. Doi: 10.1016/S1052-3359(21)00046-4.
Repositorio USMP. Tesis de maestría (2016). La Serna Albitres, Milagritos del Pilar. Fístula broncopleural en cirugía de tuberculosis pulmonar. Hospital Nacional Arzobispo Loayza 2010 – 2015. [Internet]. [Consultado 6 sept 2023]. Disponible en: https://hdl.handle.net/20.500.12727/2601.
Maekawa Y, Amez O, Castañeda E. Ventana torácica en el tratamiento del empiema pleural crónico en el Hospital Nacional Cayetano Heredia, 1990-1998. Rev Med Hered 2002;13:90–8.
Pechetov AA, Gritsuta AY, Esakov YS, Lednev AN. Transsternal occlusion of the main bronchus stump in bronchopleural fistula and non-specific pleural empyema. Khirurgiia (Mosk) 2019;(7):5–9.
Azorin J, Francisci M. Closure of a Postpneumonectomy Main Bronchus Fistula Using Video-Assisted Mediastinal Surgery. Chest 1996;109(4):1097–8. Doi: 10.1378/chest.109.4.1097.
Venissac N, Pop D, Mouroux J. Closure of left-sided bronchopleural fistula by video-assisted mediastinoscopy: Is it always possible? J Thorac Cardiovasc Surg 2006;132(6):1490–1. Doi: 10.1016/j.jtcvs.2006.09.016.
Leschber G, Klemm W, Merk J. Video-mediastinoscopic resection of a long bronchial stump and reclosure of bronchial insufficiency after pneumonectomy. Eur J Cardiothorac Surg 2009;35(6):1105–7. Doi: 10.1016/j.ejcts.2009.01.016.
Galetta D, Spaggiari L. Video-Thoracoscopic Management of Postpneumonectomy Empyema. Thorac Cardiovasc Surg 2018;66(08):701–6. Doi: 10.1055/s-0038-1677701.
De la Riviere AB, Defauw JJ, Knaepen PJ, van Swieten HA, Vanderschueren RC, van den Bosch JM. Transsternal closure of bronchopleural fistula after pneumonectomy. Ann Thorac Surg 1997;64(4):954-7; discussion 958-9. Doi: 10.1016/s0003-4975(97)00797-2.
ClagettL OT, Geraci JE. A procedure for the management of postpneumonectomy empyema. J Thorac Cardiovasc Surg 1963; 45:141-5.
Cuschieri S. The STROBE guidelines. Saudi J Anaesth 2019;13(Suppl 1) –S34. Doi: 10.4103/sja.SJA_543_18.
Massera F, Robustellini M, Pona CD, Rossi G, Rizzi A, Rocco G. Predictors of successful closure of open window thoracostomy for postpneumonectomy empyema. Ann Thorac Surg 2006;82(1):288-92. Doi: 10.1016/j.athoracsur.2005.11.046.
Solak N, Çetin M, Can MA et al. Are precautions actually a risk factor in the development of bronchopleural fistula after pneumonectomy? A retrospective analysis of 299 cases. Updates Surg 2024;76(6):2303-2311. Doi: 10.1007/s13304-024-01772-z.
De Palma A, Maruccia M, di Gennaro F. Right thoracotomy approach for treatment of left bronchopleural fistula after pneumonectomy for tuberculosis. Gen Thorac Cardiovasc Surg 2020;68(12):1539–42. Doi: 10.1007/s11748-020-01353-4.
Paleru C, Cordoş I, Dănăilă O. Transcervical Mediastinoscopic Closure of Left-Sided Postpneumonectomy Bronchial Stump Fistula. Thorac Cardiovasc Surg 2020;68(6):516–9. Doi: 10.1055/s-0040-1716034.
Torabi J, Jacob JC, Jacob JD. Tracheal Bronchus with Delayed Pleural Fistula after Pneumonectomy Managed with Eloesser Flap. Ann Thorac Surg 2022;113(2):634–6. Doi: 10.1016/j.athoracsur.2021.09.051.
Wang L, Lv Y, Zhao G et al. Therapeutic strategy and efficacy evaluation of chronic empyema after total pneumonectomy: individualized analysis of six patients. J Cardiothorac Surg 2024;19(1):688. Doi: 10.1186/s13019-024-03246-0.
Monsch GM, Etienne H, Hillinger S et al. Accelerated treatment concept in postpneumonectomy empyema with bronchopleural fistula. Sci Rep 2024;14(1):31837. Doi: 10.1038/s41598-024-83334-2.
Mazzella A, Pardolesi A, Maisonneuve P et al. Bronchopleural fistula after pneumonectomy: Risk factors and management, focusing on open window thoracostomy. J Thorac Cardiovasc Surg 2017;153(6):1452–8. Doi: 10.1016/j.jtcvs.2017.01.046.
Moreno P, Lang G, Taghavi S, Aigner C. Right-sided approach for management of left-main-bronchial stump problems. Eur J Cardiothorac Surg 2011;40(4):926–30. Doi: 10.1016/j.ejcts.2011.03.037.
Li W, Liu K, Liao X, Li B, Liang Y, Huang W. Treatment of late left bronchopleural fistula after left pneumonectomy through right thoracic approach assisted by extracorporeal membrane oxygenation. J Cardiothorac Surg 2024;19(1):308. Doi: 10.1186/s13019-024-02805-9.
Puskas JD, Mathisen DJ, Grillo HC, Wain JC, Wright CD, Moncure AC. Treatment strategies for bronchopleural fistula. J Thorac Cardiovasc Surg 1995;109(5):989-95; discussion 995-6. Doi: 10.1016/S0022-5223(95)70325-X.