Spontaneous Recovery of Completely Opened Bronchopleural Fistula with Conservative Therapy as the Most Appropriate Thoracic Drainage and Nutrition: Report of a Case

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  • Kawakami Toru
    Department of Thoracic Surgery, Aomori Prefectural Central Hospital Department of Thoracic Surgery, Fujita Health University
  • Onodera Ken
    Department of Thoracic Surgery, Aomori Prefectural Central Hospital
  • Sato Nobuyuki
    Department of Thoracic Surgery, Aomori Prefectural Central Hospital

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  • 気管支断端瘻完全離開症例に対し保存的治療が奏功した1例

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Abstract

<p>Background. Bronchopleural fistula after lung resection for lung cancer is a highly morbid complication. The treatment of this complication remains a challenge for thoracic surgeons, and few reports have shown spontaneous recovery of a completely opened bronchopleural fistula with conservative therapy. Case. A 66-year-old man underwent a right lower lobectomy for primary lung cancer, which was detected during an examination for another disease. On the 23rd post-operative day, a bronchoscopy and chest drain air leak revealed a bronchopleural fistula, which was completely opened on the 36th day after the operation. On the 65th post-operative day, however, the bronchopleural fistula had spontaneously recovered due to appropriate thoracic drainage with the chest drainage tube placed directly under the fistula, anti-biotics therapy, plus nutrition. After the recovery of the bronchopleural fistula, a high negative pressure using a drainage tube-similar to vacuum-assisted-closure therapy-was used to achieve closure of the empyema cavity on the 80th post-operative day. Conclusion. Conservative therapy may be an effective strategy for bronchopleural fistula, especially in asymptomatic patients.</p>

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