Bronchopleural fistulas developing after pulmonary resections for lung cancer predisposing factors, management, and prognosis

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

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

During the past 28 years, 55 bronchopleural fistulas (BPFs) have developed after pulmonary resections for 52 primary and 3 recurrent lung cancers at the National Cancer Center Hospital, Tokyo. During the same period, there were 2446 pulmonary resections for primary lung cancer, the incidence of BPF being 2.1%. As an operative mode of initial resections, pneumonectomy (26 cases) was most common, followed by lobectomy (20 cases), bronchoplasty (8 cases), and stump resection for recurrence (1 case). The following predisposing risk factors for BPF development were identified: resection for locally advanced lung cancer (80.8%); residual carcinomatous tissue at the resected end of bronchus or anastomosis line (29.1%); hypoalbuminemia, diabetes, or steroid administration (20%); pre- and postoperative adjuvant therapy (49.1%). Seven cases received no treatment for BPF because of sudden deaths by massive airway bleeding (5 cases), worsening pneumonia (1 case), and spontaneous recovery (1 case). Remaining 48 cases underwent treatment; tube thoracostomy only in 7 cases and surgical interventions in 41 cases, one case of which was lost during rethoracotomy due to vascular rupture. Initial surgical interventions were composed of combinations of the following procedures; direct re-suture of fistula (16 cases); amputation of the stump and re-closure (3 cases); completion pneumonectomy (6 cases); reinforcement and wrapping of fistula (27 cases); thoracoplasty (29 case). Among these 40 surgical repairs, fistula was successfully closed in 11 cases. In 5 cases, the fistula closure could be achieved after subsequent surgical procedures. Direct re-suture was successful only in 4 cases. In spite of various kinds of treatment, overall prognosis was quite poor; 37 cases died of BPF-related complications (67.3% mortality).(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)1894-1901
Number of pages8
JournalJournal of the Japanese Association for Thoracic Surgery
Volume39
Issue number10
Publication statusPublished - 1991 Oct
Externally publishedYes

Fingerprint

Causality
Fistula
Lung Neoplasms
Lung
Pneumonectomy
Sutures
Amputation Stumps
Thoracoplasty
Thoracostomy
Cancer Care Facilities
Hypoalbuminemia
Tokyo
Residual Neoplasm
Bronchi
Sudden Death
Blood Vessels
Rupture
Pneumonia
Steroids
Hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bronchopleural fistulas developing after pulmonary resections for lung cancer predisposing factors, management, and prognosis. / Asamura, Hisao; Kondo, H.; Goya, T.; Tsuchiya, R.; Naruke, T.; Suemasu, K.

In: Journal of the Japanese Association for Thoracic Surgery, Vol. 39, No. 10, 10.1991, p. 1894-1901.

Research output: Contribution to journalArticle

@article{82213008076c478fb5b5c54bacb21653,
title = "Bronchopleural fistulas developing after pulmonary resections for lung cancer predisposing factors, management, and prognosis",
abstract = "During the past 28 years, 55 bronchopleural fistulas (BPFs) have developed after pulmonary resections for 52 primary and 3 recurrent lung cancers at the National Cancer Center Hospital, Tokyo. During the same period, there were 2446 pulmonary resections for primary lung cancer, the incidence of BPF being 2.1{\%}. As an operative mode of initial resections, pneumonectomy (26 cases) was most common, followed by lobectomy (20 cases), bronchoplasty (8 cases), and stump resection for recurrence (1 case). The following predisposing risk factors for BPF development were identified: resection for locally advanced lung cancer (80.8{\%}); residual carcinomatous tissue at the resected end of bronchus or anastomosis line (29.1{\%}); hypoalbuminemia, diabetes, or steroid administration (20{\%}); pre- and postoperative adjuvant therapy (49.1{\%}). Seven cases received no treatment for BPF because of sudden deaths by massive airway bleeding (5 cases), worsening pneumonia (1 case), and spontaneous recovery (1 case). Remaining 48 cases underwent treatment; tube thoracostomy only in 7 cases and surgical interventions in 41 cases, one case of which was lost during rethoracotomy due to vascular rupture. Initial surgical interventions were composed of combinations of the following procedures; direct re-suture of fistula (16 cases); amputation of the stump and re-closure (3 cases); completion pneumonectomy (6 cases); reinforcement and wrapping of fistula (27 cases); thoracoplasty (29 case). Among these 40 surgical repairs, fistula was successfully closed in 11 cases. In 5 cases, the fistula closure could be achieved after subsequent surgical procedures. Direct re-suture was successful only in 4 cases. In spite of various kinds of treatment, overall prognosis was quite poor; 37 cases died of BPF-related complications (67.3{\%} mortality).(ABSTRACT TRUNCATED AT 250 WORDS)",
author = "Hisao Asamura and H. Kondo and T. Goya and R. Tsuchiya and T. Naruke and K. Suemasu",
year = "1991",
month = "10",
language = "English",
volume = "39",
pages = "1894--1901",
journal = "General Thoracic and Cardiovascular Surgery",
issn = "1863-6705",
publisher = "Springer Japan",
number = "10",

}

TY - JOUR

T1 - Bronchopleural fistulas developing after pulmonary resections for lung cancer predisposing factors, management, and prognosis

AU - Asamura, Hisao

AU - Kondo, H.

AU - Goya, T.

AU - Tsuchiya, R.

AU - Naruke, T.

AU - Suemasu, K.

PY - 1991/10

Y1 - 1991/10

N2 - During the past 28 years, 55 bronchopleural fistulas (BPFs) have developed after pulmonary resections for 52 primary and 3 recurrent lung cancers at the National Cancer Center Hospital, Tokyo. During the same period, there were 2446 pulmonary resections for primary lung cancer, the incidence of BPF being 2.1%. As an operative mode of initial resections, pneumonectomy (26 cases) was most common, followed by lobectomy (20 cases), bronchoplasty (8 cases), and stump resection for recurrence (1 case). The following predisposing risk factors for BPF development were identified: resection for locally advanced lung cancer (80.8%); residual carcinomatous tissue at the resected end of bronchus or anastomosis line (29.1%); hypoalbuminemia, diabetes, or steroid administration (20%); pre- and postoperative adjuvant therapy (49.1%). Seven cases received no treatment for BPF because of sudden deaths by massive airway bleeding (5 cases), worsening pneumonia (1 case), and spontaneous recovery (1 case). Remaining 48 cases underwent treatment; tube thoracostomy only in 7 cases and surgical interventions in 41 cases, one case of which was lost during rethoracotomy due to vascular rupture. Initial surgical interventions were composed of combinations of the following procedures; direct re-suture of fistula (16 cases); amputation of the stump and re-closure (3 cases); completion pneumonectomy (6 cases); reinforcement and wrapping of fistula (27 cases); thoracoplasty (29 case). Among these 40 surgical repairs, fistula was successfully closed in 11 cases. In 5 cases, the fistula closure could be achieved after subsequent surgical procedures. Direct re-suture was successful only in 4 cases. In spite of various kinds of treatment, overall prognosis was quite poor; 37 cases died of BPF-related complications (67.3% mortality).(ABSTRACT TRUNCATED AT 250 WORDS)

AB - During the past 28 years, 55 bronchopleural fistulas (BPFs) have developed after pulmonary resections for 52 primary and 3 recurrent lung cancers at the National Cancer Center Hospital, Tokyo. During the same period, there were 2446 pulmonary resections for primary lung cancer, the incidence of BPF being 2.1%. As an operative mode of initial resections, pneumonectomy (26 cases) was most common, followed by lobectomy (20 cases), bronchoplasty (8 cases), and stump resection for recurrence (1 case). The following predisposing risk factors for BPF development were identified: resection for locally advanced lung cancer (80.8%); residual carcinomatous tissue at the resected end of bronchus or anastomosis line (29.1%); hypoalbuminemia, diabetes, or steroid administration (20%); pre- and postoperative adjuvant therapy (49.1%). Seven cases received no treatment for BPF because of sudden deaths by massive airway bleeding (5 cases), worsening pneumonia (1 case), and spontaneous recovery (1 case). Remaining 48 cases underwent treatment; tube thoracostomy only in 7 cases and surgical interventions in 41 cases, one case of which was lost during rethoracotomy due to vascular rupture. Initial surgical interventions were composed of combinations of the following procedures; direct re-suture of fistula (16 cases); amputation of the stump and re-closure (3 cases); completion pneumonectomy (6 cases); reinforcement and wrapping of fistula (27 cases); thoracoplasty (29 case). Among these 40 surgical repairs, fistula was successfully closed in 11 cases. In 5 cases, the fistula closure could be achieved after subsequent surgical procedures. Direct re-suture was successful only in 4 cases. In spite of various kinds of treatment, overall prognosis was quite poor; 37 cases died of BPF-related complications (67.3% mortality).(ABSTRACT TRUNCATED AT 250 WORDS)

UR - http://www.scopus.com/inward/record.url?scp=0026233375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026233375&partnerID=8YFLogxK

M3 - Article

C2 - 1960433

AN - SCOPUS:0026233375

VL - 39

SP - 1894

EP - 1901

JO - General Thoracic and Cardiovascular Surgery

JF - General Thoracic and Cardiovascular Surgery

SN - 1863-6705

IS - 10

ER -