Bronchopleural fistulas associated with lung cancer operations

Univariate and multivariate analysis of risk factors, management, and outcome

Hisao Asamura, T. Naruke, R. Tsuchiya, T. Goya, H. Kondo, K. Suemasu

Research output: Contribution to journalArticle

184 Citations (Scopus)

Abstract

During a 28-year period, 52 bronchopleural fistulas developed after pulmonary resection of 49 primary and three recurrent lung cancers at the National Cancer Center Hospital, Tokyo. During the same period there were 2359 pulmonary resections for primary lung cancer; the prevalence of bronchopleural fistula was 2.1%. Multivariate analysis on 15 variables in the most recent 1360 resections revealed significant risk factors for bronchopleural fistula: wider resection such as pneumonectomy, residual carcinomatous tissue at the bronchial stump, preoperative irradiation, and diabetes. Univariate analysis further recognized a risk in preoperative bronchial arterial infusion and the postsurgical stage of lung cancer. Six patients were not treated. Apart from chest tube drainage in seven patients, surgical repair was attempted in 39, direct resuture of the stump in 16, wrapping in 25, thoracoplasty in 31, completion pneumonectomy in 6, and other treatments. Despite various treatments, 37 patients (71.2% mortality) died from fistula-related complications (such as regurgitation of infected pleural fluid through the fistula and airway/intrathoracic bleeding). Even for patients whose fistulas were cured and who were discharged, the average hospital stay was 189 days. Further investigation is necessary to answer whether prevention by flap coverage is of any benefit.

Original languageEnglish
Pages (from-to)1456-1464
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume104
Issue number5
Publication statusPublished - 1992
Externally publishedYes

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Risk Management
Fistula
Lung Neoplasms
Multivariate Analysis
Pneumonectomy
Thoracoplasty
Cancer Care Facilities
Chest Tubes
Lung
Tokyo
Residual Neoplasm
Drainage
Length of Stay
Hemorrhage
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Bronchopleural fistulas associated with lung cancer operations : Univariate and multivariate analysis of risk factors, management, and outcome. / Asamura, Hisao; Naruke, T.; Tsuchiya, R.; Goya, T.; Kondo, H.; Suemasu, K.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 104, No. 5, 1992, p. 1456-1464.

Research output: Contribution to journalArticle

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