Abstract
Objective
The aim of this article was to clarify recent risk factors for the early bronchopleural fistula after anatomical lung resection.
Methods
Reports on early bronchopleural fistula after anatomical lung resection in adults, including information on risk factors, published between 2006 and 2016 were reviewed and our institutional data were evaluated. The early period was defined as within 30 days from surgery or as described early in the manuscript.
Results
A total of seven retrospective observational articles were selected. Four articles investigated lobectomy and pneumonectomy, while the other three articles investigated only pneumonectomy. The surgical procedure, preoperative therapy, complications after surgery, right side, patient age, past history, and tumor residuals were mentioned as risk factors of bronchopleural fistula. Our data concluded that neoadjuvant therapy and a right lower lobe location were risk factors after a lobectomy, while a right side and complete pneumonectomy were risk factors after a pneumonectomy.
Conclusions
Although recent studies have reached nearly the same conclusions as older reports, continuous research of potential risk factor is needed as therapeutic procedures continue to evolve.
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Abbreviations
- BPF:
-
Bronchopleural fistula
- NSCLC:
-
Non-small cell lung cancer
- EGFR:
-
Epithelial growth factor receptor
- TKI:
-
Tyrosine kinase inhibitor
- ALK:
-
Anaplastic lymphoma kinase
- PD-L1:
-
Programmed cell death ligand 1
References
Di Maio M, Perrone F, Deschamps C, Rocco G. A metaanalysis of the impact of bronchial stump coverage on the risk of bronchopleural fistula after pneumonectomy. Eur J Cardiothorac Surg. 2015;48:196–200.
Shekar K, Foot C, Fraser J, Ziegenfuss M, Hopkins P, Windsor M. Bronchopleural fistula: an update for intensivists. J Crit Care. 2010;25:47–55.
Sirbu H, Busch T, Aleksic I, Schreiner W, Oster O, Dalichau H. Bronchopleural fistula in the surgery of non-small cell lung cancer: incidence, risk factors, and management. Ann Thorac Cardiovasc Surg. 2001;7:330–6.
Sonobe M, Nakagawa M, Ichinose M, Ikegami N, Nagasawa M, Shindo T. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung cancer. Eur J Cardiothorac Surg. 2000;18:519–23.
Satoh Y, Okumura S, Nakagawa K, Horiike A, Ohyanagi F, Nishio M, et al. Postoperative ischemic change in bronchial stumps after primary lung cancer resection. Eur J Cardiothorac Surg. 2006;30(1):172–6.
Yamamoto R, Tada H, Kishi A, Tojo T. Effects of preoperative chemotherapy and radiation therapy on human bronchial blood flow. J Thorac Cardiovasc Surg. 2000;119:939–45.
Benhamed L, Bellier J, Fournier C, Akkad R, Mathieu D, Kipnis E, et al. Postoperative ischemic bronchitis after lymph node dissection and primary lung cancer resection. Ann Thorac Surg. 2011;91:355–9.
Zakkar M, Kanagasabay R, Hunt I. No evidence that manual closure of the bronchial stump has a lower failure rate than mechanical stapler closure following anatomical lung resection. Interact Cardiovasc Thorac Surg. 2014;18:488–49.
Kawaguchi T, Watanabe S, Kawachi R, Suzuki K, Asamura H. The impact of residual tumor morphology on prognosis, recurrence, and fistula formation after lung cancer resection. J Thorac Oncol. 2008;3:599–603.
Jichen QV, Chen G, Jiang G, Ding J, Gao W, Chen C. Risk factor comparison and clinical analysis of early and late bronchopleural fistula after non-small cell lung cancer surgery. Ann Thorac Surg. 2009;88:1589–93.
d’Amato TA, Ashrafi AS, Schuchert MJ, Alshehab DS, Seely AJ, Shamji FM, et al. Risk of pneumonectomy after induction therapy for locally advanced non small cell lung cancer. Ann Thorac Surg. 2009;88:1079–85.
Uramoto H, Hanagiri T. The development of bronchopleural fistula in lung cancer patients after major surgery: 31 years of experience with 19 cases. Anticancer Res. 2011;31:619–24.
Puri V, Tran A, Bell JM, Crabtree TD, Kreisel D, Krupnick AS, et al. Completion pneumonectomy: outcomes for benign and malignant indications. Ann Thorac Surg. 2013;95:1885–90.
Hu XF, Duan L, Jiang GN, Wang H, Liu HC, Chen C. A clinical risk model for the evaluation of bronchopleural fistula in non-small cell lung cancer after pneumonectomy. Ann Thorac Surg. 2013;96:419–24.
Kobayashi S, Karube Y, Nishihira M, Inoue T, Araki O, Maeda S, et al. Postoperative pyothorax a risk factor for acute exacerbation of idiopathic interstitial pneumonia following lung cancer resection. Gen Thorac Cardiovasc Surg. 2016;64:476–80.
Li S, Fan J, Zhou J, Ren Y, Shen C, Che G. Residual disease at the bronchial stump is positively associated with the risk of bronchoplerual fistula in patients undergoing lung cancer surgery: a meta-analysis. Interact Cardiovasc Thorac Surg. 2016;22:327–35.
Li S, Fan J, Liu J, Zhou J, Ren Y, Shen C, et al. Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14912 patients. Jpn J Clin Oncol. 2016;46:534–46.
Li SJ, Fan J, Zhou J, Ren YT, Shen C, Che GW. Diabetes mellitus and risk of bronchopleural fistula after pulmonary resections: a meta-analysis. Ann Thorac Surg. 2016;102:328–39.
Li SJ, Zhou XD, Huang J, Liu J, Tian L, Che GW. A systematic review and meta-analysis-does chronic obstructive pulmonary disease predispose to bronchopleural fistula formation in patients undergoing lung cancer surgery? J Thorac Dis. 2016;8:1625–38.
Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery. Thoracic and cardiovascular surgery in Japan during 2014. Gen Thorac Cardiovasc Surg. 2016;64:665–97.
Takahashi S, Go T, Kasai Y, Yokomise H, Shibata T. Relationship between dose-volume parameters and pulmonary complications after neoadjuvant chemoradiotherapy followed by surgery for lung cancer. Strahlenther Onkol. 2016;192:658–67.
Matsuoka K, Imanishi N, Yamada T, Matsuoka T, Nagai S, Ueda M, et al. Clinical results of bronchial stump coverage using free pericardial fat pad. Interact Cardiovasc Thorac Surg. 2016;23:553–9.
Brewer LA 3rd, Bai AF. Surgery of the bronchi and trachea: experience with the pedicled pericardial fat graft reinforcement. Am J Surg. 1955;89:331–46.
Yokomise H, Takahashi Y, Inui K, Yagi K, Mizuno H, Aoki M, et al. Omentoplasty for postpneumonectomy bronchopleural fistulas. Eur J Cardiothorac Surg. 1994;8:122–4.
Shrager JB, Wain JC, Wright CD, Donahue DM, Vlahakes GJ, Moncure AC, et al. Omentum is highly effective in the management of complex cardiothoracic surgical problems. J Thorac Cardiovasc Surg. 2003;125:526–32.
Sfyridis PG, Kapetanakis EI, Baltayiannis NE, Bolanos NV, Anagnostopoulos DS, Markogiannakis A, et al. Bronchial stump buttressing with an intercostal muscle flap in diabetic patients. Ann Thorac Surg. 2007;84:967–71.
Watanabe S, Asamura H, Suzuki K, Tsuchiya R. Recent results of postoperative mortality for surgical resections in lung cancer. Ann Thorac Surg. 2004;78:999–1003.
Dickhoff C, Dahele M, Paul MA, van de Ven PM, de Langen AJ, Senan S, et al. Salvage surgery for locoregional recurrence or persistent tumor after high dose chemoradiotherapy for locally advanced non-small cell lung cancer. Lung Cancer. 2016;94:108–13.
Shimada Y, Suzuki K, Okada M, Nakayama H, Ito H, Mitsudomi T, et al. Feasibility and efficacy of salvage lung resection after definitive chemoradiation therapy for Stage III non-small-cell lung cancer. Interact Cardiovasc Thorac Surg. 2016;23:895–901.
The Japan Lung Cancer Society. Japan Guidelines of Lung Cancer Therapy. 2016. [Internet]. Japan: Kanehara Shuppan 2017. https://www.haigan.gr.jp/modules/guideline/index.php?content_id=3. Accessed June 2017.
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Okuda, M., Go, T. & Yokomise, H. Risk factor of bronchopleural fistula after general thoracic surgery: review article. Gen Thorac Cardiovasc Surg 65, 679–685 (2017). https://doi.org/10.1007/s11748-017-0846-1
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DOI: https://doi.org/10.1007/s11748-017-0846-1