HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by al-Kattan, K. Articles by Goldstraw, P. Search for Related Content PubMed PubMed Citation Articles by al-Kattan, K. Articles by Goldstraw, P.

The Annals of Thoracic Surgery, Vol 58, 1433-1436, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Bronchopleural fistula after pneumonectomy with a hand suture technique

K al-Kattan, L Cattalani and P Goldstraw
Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, United Kingdom.

We have reviewed the incidence of bronchopleural fistula among 530 consecutive pneumonectomies, all carried out by one surgical team using a uniform suture technique between January 1980 and November 1993. There were 7 fistulas (1.3%); all of them occurred within 15 days postoperatively. There were no cases of late fistula during a mean follow-up period of 23 months. The pathology for which pneumonectomy was undertaken was primary lung malignancies in 488 cases (92.1%), metastatic disease in 15 cases (2.8%), and benign diseases in 27 cases (5.1%). All fistulas developed after pneumonectomy for lung cancer. Other risk factors included age, preoperative radiotherapy, and the surgeon's level of experience, as only two fistulas occurred with the consultant who performed 410 pneumonectomies (0.5%). The bronchial stump was free of tumor in all cases. There were no fistulas in the 37 completion pneumonectomies (7%). All fistulas were treated within 2 days of diagnosis by resuturing the stump through the initial thoracotomy incision. That was successful in 5 patients, whereas fatal complications developed in the other 2 patients. We believe that suture closure of the bronchial stump at pneumonectomy provides a cheap and reliable technique that gives good results in all situations.

This article has been cited by other articles:

				P. G. Sfyridis, E. I. Kapetanakis, N. E. Baltayiannis, N. V. Bolanos, D. S. Anagnostopoulos, A. Markogiannakis, and A. Chatzimichalis Bronchial Stump Buttressing With an Intercostal Muscle Flap in Diabetic Patients Ann. Thorac. Surg., September 1, 2007; 84(3): 967 - 971. [Abstract] [Full Text] [PDF]

				V. Getman, E. Devyatko, D. Abraham, D. Dunkler, E. Wolner, S. Aharinejad, and M. R. Mueller Reconstitution of Blood Supply of the Denuded Bronchial Stump Ann. Thorac. Surg., December 1, 2005; 80(6): 2063 - 2069. [Abstract] [Full Text] [PDF]

				C. Ludwig, U. Hoffarth, J. Haberstroh, W. Schuttler, B. Passlick, and E. Stoelben Resistance to pressure of the stump after mechanical stapling or manual suture. An experimental study on sheep main bronchus Eur. J. Cardiothorac. Surg., April 1, 2005; 27(4): 693 - 696. [Abstract] [Full Text] [PDF]

				H. Asamura, K. Suzuki, H. Kondo, and R. Tsuchiya Mechanical vascular division in lung resection Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 879 - 882. [Abstract] [Full Text] [PDF]

				F. J. Algar, A. Alvarez, J. L. Aranda, A. Salvatierra, C. Baamonde, and F. J. Lopez-Pujol Prediction of early bronchopleural fistula after pneumonectomy: a multivariate analysis Ann. Thorac. Surg., November 1, 2001; 72(5): 1662 - 1667. [Abstract] [Full Text] [PDF]

				K. Al-Kattan, M. Ashour, W. Hajjar, M. Salah El Din, M. Fouda, and A. Al Bakry Surgery for pulmonary aspergilloma in post-tuberculous vs. immuno-compromised patients Eur. J. Cardiothorac. Surg., October 1, 2001; 20(4): 728 - 733. [Abstract] [Full Text] [PDF]

				C. Deschamps, A. Bernard, F. C. Nichols III, M. S. Allen, D. L. Miller, V. F. Trastek, G. D. Jenkins, and P. C. Pairolero Empyema and bronchopleural fistula after pneumonectomy: factors affecting incidence Ann. Thorac. Surg., July 1, 2001; 72(1): 243 - 248. [Abstract] [Full Text] [PDF]

				D. F. Blyth Pneumonectomy for inflammatory lung disease Eur. J. Cardiothorac. Surg., October 1, 2000; 18(4): 429 - 434. [Abstract] [Full Text] [PDF]

				J. H Khan, S. B Rahman, D. B McElhinney, A. L Harmon, J. P Anthony, T. S Hall, D. M Jablons, J. H Khan, S. B Rahman, D. B McElhinney, et al. Management Strategies for Complex Bronchopleural Fistula Asian Cardiovasc Thorac Ann, March 1, 2000; 8(1): 78 - 84. [Abstract] [Full Text] [PDF]

				H. Asamura, H. Kondo, and R. Tsuchiya Management of the bronchial stump in pulmonary resections: a review of 533 consecutive recent bronchial closures Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 106 - 110. [Abstract] [Full Text] [PDF]

				S. Deb and P. Fonseca Respiratory Distress Following Pneumonectomy Chest, November 1, 1999; 116(5): 1461 - 1463. [Full Text] [PDF]

				A. El-Gamel, G.M.K. Tsang, and D.C.T. Watson The threshold for air leak: stapled versus sutured human bronchi, an experimental study Eur. J. Cardiothorac. Surg., January 1, 1999; 15(1): 7 - 10. [Abstract] [Full Text] [PDF]

				D. Grunenwald and L. Spaggiari Technique for Early Bronchopleural Fistula Repair After Lung Resection Ann. Thorac. Surg., April 1, 1997; 63(4): 1214 - 1215. [Full Text]

				K. Al-Kattan and P. Goldstraw COMPLETION PNEUMONECTOMY: INDICATIONS AND OUTCOME J. Thorac. Cardiovasc. Surg., October 1, 1995; 110(4): 1125 - 1129. [Abstract] [Full Text]

				D. Metras and P. Goldstraw Bronchopleural Fistula After Pneumonectomy Ann. Thorac. Surg., August 1, 1995; 60(2): 490 - 492. [Full Text]

				S. Victor, V. M. Nayak, M. Kabeer, and P. Goldstraw To Staple, Suture, or Ligate the Bronchus Ann. Thorac. Surg., July 1, 1995; 60(1): 228 - 229. [Full Text]