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Journal of Thoracic Disease Oct 2023
PubMed: 37969259
DOI: 10.21037/jtd-23-1231 -
Journal of Thoracic Disease Nov 2023
PubMed: 38090305
DOI: 10.21037/jtd-2023-13 -
Journal of Cardiothoracic Surgery Jul 2023The study aimed to assess the magnitude, risk factors, and management outcome of patients with a bronchopleural fistula at multiple centres in Ethiopia.
PURPOSE
The study aimed to assess the magnitude, risk factors, and management outcome of patients with a bronchopleural fistula at multiple centres in Ethiopia.
METHOD AND MATERIALS
A ten years (September 2012 - August 2021) institution-based multicenter retrospective cohort study was conducted from September 13 to September 30, 2021. we surveyed the cards of all patients having a diagnosis of bronchopleural fistula for the last 10 years. The document was reviewed using an extraction checklist. Descriptive statistics (mean, standard deviation, frequency, percentages) and crosstabulation were used to describe the outcome variable.
RESULT
A total of 52(2%) patients were diagnosed to have bronchopleural fistula out of 2546 patients admitted to the cardiothoracic unit in three hospitals from September 2012 - August 2021 and 69% of study participants were male. The mean age of study participants was 33.42 years with SD = 12.5. Thirty-one (60%) of the cases spontaneously developed a bronchopleural fistula and 20 (38%) were post-surgical and 1(2%) was a post-traumatic fistula. Of the total of post-surgical bronchopleural fistula, 14 (26.9%) of them were lung resection, 4 (7.7%) were hydatid cystectomy and 1(1.9%) are decortications, and bullectomy respectively. of the total post-lung resection, 8 (57%) were pneumonectomies followed by 3 (21.5%) Lobectomy, 2 (14.5%) wedge resection and 1(7%) bilobectomy respectively. Fifty patients were managed surgically and two patients were managed conservatively. Bronchopleural fistula (BPF) was closed in 40 (85.4%) and there were two (3.9%) deaths, and the cause of death was sepsis secondary to pneumonia of the contralateral lung in one case.
CONCLUSION
Having thoracic surgery is a risk factor for the development of bronchopleural fistula. Management of bronchopleural fistula needs to be individualized.
Topics: Humans; Male; Adult; Female; Prevalence; Ethiopia; Retrospective Studies; Treatment Outcome; Bronchi; Pleural Diseases
PubMed: 37438756
DOI: 10.1186/s13019-023-02325-y -
Emergency Medicine International 2023Bronchopleural fistula (BPF) is a serious and life-threatening complication. Following the advent of interventional radiology, subsequent treatment methods for BPF have... (Review)
Review
OBJECTIVES
Bronchopleural fistula (BPF) is a serious and life-threatening complication. Following the advent of interventional radiology, subsequent treatment methods for BPF have gradually diversified. Therefore, this article provides an overview of the present scenario of interventional treatment and research advancements pertaining to BPF.
METHODS
Relevant published studies on the interventional treatment of BPF were identified from the PubMed, Sci-Hub, Google Scholar, CNKI, VIP, and Wanfang databases. The included studies better reflect the current status of and progress in interventional treatments for BPF with representativeness, reliability, and timeliness. Studies with similar and repetitive conclusions were excluded.
RESULTS
There are many different interventional treatments for BPF that can be applied in cases of BPF with different fistula diameters.
CONCLUSION
The application of interventional procedures for bronchopleural fistula has proven to be safe, efficacious, and minimally invasive. However, the establishment of comprehensive, standardized treatment guidelines necessitates further pertinent research to attain consensus within the medical community. The evolution of novel technologies, tools, techniques, and materials specifically tailored to the interventional management of bronchopleural fistula is anticipated to be the focal point of forthcoming investigations. These advancements present promising prospects for seamless translation into clinical practice and application, thereby potentially revolutionizing patient care in this field.
PubMed: 37398639
DOI: 10.1155/2023/8615055 -
Journal of Personalized Medicine Nov 2023Stem cells are undifferentiated cells presenting extensive self-renewal features and the ability to differentiate "in vitro" and "in vivo" into a range of lineage cells,... (Review)
Review
Stem cells are undifferentiated cells presenting extensive self-renewal features and the ability to differentiate "in vitro" and "in vivo" into a range of lineage cells, like chondrogenic, osteogenic and adipogenic lineages when cultured in specific inducing media. Two major domains of clinical applications of stem cells in thoracic surgery have been investigated: regenerative medicine, which is a section of translational research in tissue engineering focusing on the replacement, renewal or regeneration of cells, tissues and organs to re-establish damaged physiologic functions; drug loading and delivery, representing a new branch proposing stem cells as carriers to provide selected districts with anti-cancer agents for targeted treatments.
PubMed: 38138859
DOI: 10.3390/jpm13121632 -
The Korean Journal of Internal Medicine Jul 2023
Topics: Humans; Bronchial Fistula; Pleural Diseases; Pneumonectomy; Postoperative Complications
PubMed: 36967593
DOI: 10.3904/kjim.2023.060 -
Microbiology Spectrum Apr 2024Aspergillus pleurisy is a rare complication of invasive pulmonary aspergillosis (IPA), which mostly occurs in the immunocompromised host. The clinical condition is... (Review)
Review
UNLABELLED
Aspergillus pleurisy is a rare complication of invasive pulmonary aspergillosis (IPA), which mostly occurs in the immunocompromised host. The clinical condition is critical, especially to those who develop bronchopleural fistula. This study aimed to assess the characteristics and the prognosis of aspergillus pleurisy. Clinical data from 13 patients diagnosed with aspergillus pleurisy in our hospital from January 2000 to December 2022 were retrospectively studied. Thirteen patients with pleurisy were included. There were 10 males and 3 females, with a median age of 65 (range: 18-79) years. Bronchopleural fistula was present in eight patients. A proven diagnosis of pleurisy was based on positive pleural fluid culture in seven cases and histopathological examination of pleural biopsies in six cases. Four patients refused further treatment and were discharged from the hospital against medical advice. Nine cases recovered and were discharged after multiple antifungal treatments (systemic and topical antifungal therapies, pleural drainage and irrigation, and surgical repair). During follow-up, one patient, who suffered underlying bronchiectasis, died of massive hemoptysis 2 years after discharge. The remaining eight cases are still under close follow-up, with a median follow-up of 5.4 (range: 1.3-18.9) years. The prognosis of aspergillus pleurisy complicated with bronchopleural fistula is poor. Thoracic surgery, especially lung resection, is a risk factor associated with the incidence of pleurisy. Systemic antifungal therapy and adequate pleural irrigation could improve the prognosis.
IMPORTANCE
Aspergillus pleurisy is a rare complication of invasive pulmonary aspergillosis (IPA), associated with a poor prognosis. The morbidity and mortality of this condition have not been thoroughly studied, and recent research on this topic is limited. The current study included 13 patients diagnosed with Aspergillus pleurisy, with the majority presenting concomitantly with a bronchopleural fistula. Among these patients, nine had a history of thoracic surgery, including lung transplantation and lobectomy. Four patients refused further treatment and were discharged against medical advice, while one patient succumbed to massive hemoptysis 2 years after discharge. This case series provides essential insights into Aspergillus pleurisy and evaluates the therapeutic strategy based on a limited cohort.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Aged; Invasive Pulmonary Aspergillosis; Antifungal Agents; Hemoptysis; Retrospective Studies; Aspergillus; Pleurisy; Fistula
PubMed: 38411055
DOI: 10.1128/spectrum.03852-23 -
Journal of Thoracic Disease Jun 2023Bronchopleural fistula (BPF) after lobectomy for lung cancer is a rare but serious complication. This study aimed to stratify the risk factors of BPF.
BACKGROUND
Bronchopleural fistula (BPF) after lobectomy for lung cancer is a rare but serious complication. This study aimed to stratify the risk factors of BPF.
METHODS
Patients who underwent lobectomy without bronchoplasty and preoperative treatment for lung cancer between 2005 and 2020 were retrospectively reviewed. We examined the association between the incidence of BPF and background factors, including comorbidities, preoperative blood test results, respiratory function, surgical procedure, and extent of lymphadenectomy.
RESULTS
Among the 3,180 patients who underwent lobectomy, 14 (0.44%) developed BPF. The median interval from surgery to BPF onset was 21 days (range, 10-287). Two of the 14 patients died of BPF (mortality rate, 14%). All 14 patients who developed BPF were men and had undergone right lower lobectomy. Other factors significantly associated with the development of BPF were older age, heavy smoking, obstructive ventilatory failure, interstitial pneumonia, history of malignancy, history of gastric cancer surgery, low serum albumin levels, and histology. Multivariable analysis in the subgroup of men who underwent right lower lobectomy revealed that high level of serum C-reactive protein and a history of gastric cancer surgery were significantly associated with BPF, whereas bronchial stump coverage was inversely associated with BPF.
CONCLUSIONS
Men who underwent right lower lobectomy were at increased risk of BPF. The risk was higher when the patient had high serum C-reactive protein or a history of gastric cancer surgery. Bronchial stump coverage might be effective in patients at high risk of BPF.
PubMed: 37426169
DOI: 10.21037/jtd-22-1809 -
Journal of Postgraduate Medicine 2024We present a 19-year-old woman, a case of Lemierre syndrome, who presented with fever, sore throat, and left shoulder pain. Imaging revealed a thrombus in the right...
We present a 19-year-old woman, a case of Lemierre syndrome, who presented with fever, sore throat, and left shoulder pain. Imaging revealed a thrombus in the right internal jugular vein, multiple nodular shadows below both pleura with some cavitations, right lung necrotizing pneumonia, pyothorax, abscess in the infraspinatus muscle, and multiloculated fluid collections in the left hip joint. After inserting a chest tube and administering urokinase for the pyothorax, a bronchopleural fistula was suspected. The fistula was identified based on clinical symptoms and computed tomography scan findings. If a bronchopleural fistula is present, thoracic lavage should not be performed as it may cause complications such as contralateral pneumonia due to reflux.
Topics: Female; Humans; Young Adult; Adult; Lemierre Syndrome; Bronchial Fistula; Pleural Diseases; Empyema, Pleural; Pneumonia
PubMed: 37376756
DOI: 10.4103/jpgm.jpgm_722_22