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Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC

Received: 2 May 2022    Accepted: 23 May 2022    Published: 9 June 2022
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Abstract

Bronchogenic fistula with or without empyema is considered among the most life - threatening complications in lung resections. Many proceedings to treat this kind of fistula have been described in Literature, most of them are very aggressive indeed (re - do thoracotomy, re - do bronchial anastomosis, open window thoracostomy). This is a report about a patient who developped broncho – pleural fistula after nearly sixt months from right pneumonectomy fot NSCLC. Unexpectedly in this case healing was spontaneous and requested only a chest drainage and antibiotics. Probably in this patient the fistula at the right main bronchial stump occurred on the basis of a somewhat disorder of the riparative and inflammation pathway. Propensity to infective disease (previous TB end Staphylococcus infection) could confirm this explanation.

Published in Journal of Surgery (Volume 10, Issue 3)
DOI 10.11648/j.js.20221003.16
Page(s) 121-124
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Broncho - Pleural Fistula, Immunological Disoders, Spontaneous Healing

References
[1] Eerola S, Virkkula L, Varstela E. Treatement of postpneumonectomy empyema and associated bronchopleural fistula. Experience of 100 consecutive postpneumonectomy patients. Scand J Thorac Cardiovasc Surg. 1988; 22: 235-9.
[2] Massard G, Lyons G, Wihlm JM, Fernoux P, Dumont P, Kessler R et al. Early and long – term results after completion pneumonectomy. Ann Thorac Surg. 1995; 59: 196-200.
[3] Higgins GA, Beebe GW. Bronchogenic carcinoma. Factors in survival. Arch Surg. 1967; 94: 539-49.
[4] Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg. 1992; 54: 84-8.
[5] R J Cerfolio. The incidence, etiology, and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg 2001 Jan; 13 (1): 3-7.
[6] Claudio Andreetti, Cecilia Menna, Antonio D'Andrilli, Moshen Ibrahim, Giulio Maurizi, camilla Poggi, Erino Angelo Rendina, Federico Venuta, Mario Santini, Alfonso Fiorelli. Multimodal Treatment for Post-Pneumonectomy Bronchopleural Fistula Associated With Emyema. Ann Thorac Surg 2018 Dec; 106 (6): -e337-e339.
[7] P H Hollaus, M Huber, F Lax, P N Wurning, G Bohm, N S Pridun. Closure of bronchopleural fistula after pneumonectomy with a pedicled intercostal muscle flap. Eur J Cardiothorac Surg 1999 Aug; 16 (2): 181-6.
[8] T C Mineo, V Ambrogi. Early closure of the postpneumonectomy bronchopleural fistula by pedicled diaphragmatic flaps. Ann Thorac Surg 1995Sep; 60 (3): 714-5.
[9] K Athanassiadi, K Vassilikos, P Misthos, N Theakos, S Kakaris, E Sepsas, I Skottis. Late postpneumonectomy bronchopleural fistula. Thorac Cardiovasc Surg 2004 Oct; 52 (5): 298-301.
[10] Scarci, Marco, Udo Abah, Piergiorgio Solli, Aravinda Page, David Waller, Paul van Schil, Franca Melfi et al. “EACTS expert consensus statement for surgical management of pleural empyema”. European journal of cardio-thoracic surgery 48, no. 5 (2015): 642 – 653.
[11] Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari. Bronchopleural Fistula After Pneumonectomy: Risk Factors and Management, Focusing on Open – Window Thoracostomy. Semin Thorac Cardiovasc Surg. Spring 2018; 30 (1): 04-113.
[12] Domenico Galetta, Lorenzo Spaggiari. Video – Thoarcoscopic Management of Postpneumonectomy Empyema. Thorac Cardiovasc Surg 2018; 66 (08): 701-706.
[13] 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: 954-7.
[14] Deschamps C, Bernard A, Nichols FC, Allen MS, Miller DL, Trastek VF et al. Empyema and bronchopleural fistula after pneumonectomy: factors affecting incidence. Ann Thorac Surg. 2001; 72: 243-8.
[15] Da-Li Wang, Gui-Yu Cheng, Ke-Li Sun, Ping -Jin Meng, De-Kang Fang, Jie He. Treatement and prevention of bronchus-pleural fistula after pneumonectomy for lung cancer. Zhonghua Wai Ke Za Zhi. 2008 Feb 1; 46 (3): 193-5.
[16] Eric A Engels. Inflammation in the development of lung cancer: epidemiolgical evidence. Expert Rev Anticancer Ther. 2008 Apr; 8 (4): 605-15.
[17] Michael Dougan, Li D, Neuberg D, Mihm M, Googe P, Wong KK, Dranoff G. A dual role for the immune response in a mouse model of inflammation-associated lung cancer. J Clin Invest 2011 Jun; 121 (6): 2436-46.
[18] Liku B Tezera, Bielecka MK, Ogongo P, Walker NF, Ellis M, Garay-Baquero DJ, Thomas K, Reichmann MT, Johnston DA, Wilkinson KA, Ahmed M, Jogai S, Jayasinghe Sn, Wilkinson RJ, Mansour S, Thomas GJ, Ottensmeier CH, Leslie A, Elkington PT. Anti-PD-1 immunotherapy leads to tuberculosis reactivation via dysregulation of TNF-α Elife. 2020 Feb 24; 9: e52668.
[19] Jirì Simek, Pavel Zàcek, Zdenek Vacek, Josef Novotny, Milan Stetina, Petr Habal. Bronchopleural fistula after pneumonectomy. Acta Medica (Hradec Kralove) Suppl 2002; 45 (1): 19-24.
Cite This Article
  • APA Style

    Flavio Colaut, Aurelio Piazza, Tommaso Stecca, Micaela Romagnoli, Catino Cosimo, et al. (2022). Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC. Journal of Surgery, 10(3), 121-124. https://doi.org/10.11648/j.js.20221003.16

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    ACS Style

    Flavio Colaut; Aurelio Piazza; Tommaso Stecca; Micaela Romagnoli; Catino Cosimo, et al. Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC. J. Surg. 2022, 10(3), 121-124. doi: 10.11648/j.js.20221003.16

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    AMA Style

    Flavio Colaut, Aurelio Piazza, Tommaso Stecca, Micaela Romagnoli, Catino Cosimo, et al. Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC. J Surg. 2022;10(3):121-124. doi: 10.11648/j.js.20221003.16

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  • @article{10.11648/j.js.20221003.16,
      author = {Flavio Colaut and Aurelio Piazza and Tommaso Stecca and Micaela Romagnoli and Catino Cosimo and Giovanni Morana and Marco Massani},
      title = {Iconography, Physiopathology and Spontaneous Healing of a Broncho – Pleural Fistula Following a Right Pneumonectomy for NSCLC},
      journal = {Journal of Surgery},
      volume = {10},
      number = {3},
      pages = {121-124},
      doi = {10.11648/j.js.20221003.16},
      url = {https://doi.org/10.11648/j.js.20221003.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221003.16},
      abstract = {Bronchogenic fistula with or without empyema is considered among the most life - threatening complications in lung resections. Many proceedings to treat this kind of fistula have been described in Literature, most of them are very aggressive indeed (re - do thoracotomy, re - do bronchial anastomosis, open window thoracostomy). This is a report about a patient who developped broncho – pleural fistula after nearly sixt months from right pneumonectomy fot NSCLC. Unexpectedly in this case healing was spontaneous and requested only a chest drainage and antibiotics. Probably in this patient the fistula at the right main bronchial stump occurred on the basis of a somewhat disorder of the riparative and inflammation pathway. Propensity to infective disease (previous TB end Staphylococcus infection) could confirm this explanation.},
     year = {2022}
    }
    

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    AU  - Flavio Colaut
    AU  - Aurelio Piazza
    AU  - Tommaso Stecca
    AU  - Micaela Romagnoli
    AU  - Catino Cosimo
    AU  - Giovanni Morana
    AU  - Marco Massani
    Y1  - 2022/06/09
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    N1  - https://doi.org/10.11648/j.js.20221003.16
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    JF  - Journal of Surgery
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    AB  - Bronchogenic fistula with or without empyema is considered among the most life - threatening complications in lung resections. Many proceedings to treat this kind of fistula have been described in Literature, most of them are very aggressive indeed (re - do thoracotomy, re - do bronchial anastomosis, open window thoracostomy). This is a report about a patient who developped broncho – pleural fistula after nearly sixt months from right pneumonectomy fot NSCLC. Unexpectedly in this case healing was spontaneous and requested only a chest drainage and antibiotics. Probably in this patient the fistula at the right main bronchial stump occurred on the basis of a somewhat disorder of the riparative and inflammation pathway. Propensity to infective disease (previous TB end Staphylococcus infection) could confirm this explanation.
    VL  - 10
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Author Information
  • General Surgery and Toracic, “Cà Foncello” Regional Hospital, Treviso, Italy

  • General Surgery and Toracic, “Cà Foncello” Regional Hospital, Treviso, Italy

  • General Surgery and Toracic, “Cà Foncello” Regional Hospital, Treviso, Italy

  • Pulmonology and Thoracic Endoscopy, “Cà Foncello” Regional Hospital, Treviso, Italy

  • Pulmonology and Thoracic Endoscopy, “Cà Foncello” Regional Hospital, Treviso, Italy

  • Radiology, “Cà Foncello” Regional Hospital, Treviso, Italy

  • General Surgery and Toracic, “Cà Foncello” Regional Hospital, Treviso, Italy

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