Combining Minimally Invasive Techniques in Managing a Frail Patient with Postpneumonectomy Bronchopleural Fistula.
Journal
Case reports in pulmonology
ISSN: 2090-6846
Titre abrégé: Case Rep Pulmonol
Pays: United States
ID NLM: 101585355
Informations de publication
Date de publication:
2021
2021
Historique:
received:
07
01
2021
revised:
09
03
2021
accepted:
23
03
2021
entrez:
5
7
2021
pubmed:
6
7
2021
medline:
6
7
2021
Statut:
epublish
Résumé
A postpneumonectomy bronchopleural fistula is a life-threatening complication requiring aggressive treatment and early repair. Reoperations are common due to initial treatment failure. Advanced bronchoscopic techniques are rapidly evolving, but permanent results are questionable. We report the minimally invasive management of a frail 79-year-old patient with postpneumonectomy fistula in respiratory failure due to repeated infections. Previous bronchoscopic closure attempts with fibrin failed. The multistep interdisciplinary management included airway surveillance by virtual bronchoscopy, percutaneous fibrin glue instillation under computed tomography, and awake thoracoscopic surgery to achieve temporary closure. This provided an acceptable long period of symptomatic and physical improvement. The bronchial stump failed again four months later, and the patient succumbed to pneumonia. Pneumonectomy has to be avoided unless strongly indicated. Complications are best managed with surgery for definite treatment. We emphasize our approach only when a patient declines surgery or is medically unfit as a temporary time-buying strategy in view of definite surgery in a high-volume center.
Identifiants
pubmed: 34221531
doi: 10.1155/2021/5513136
pmc: PMC8221083
doi:
Types de publication
Case Reports
Langues
eng
Pagination
5513136Informations de copyright
Copyright © 2021 Kostas Kostopanagiotou et al.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest relevant to this article to disclose.
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