Combined method for post-pneumonectomy bronchial fistula treatment: a new sound of the old problem

Grubnik V.V.1, Dushko N.E.2

Summary. Introduction. Pneumonectomy is a popular operation in thoracic surgery and oncological surgery. The main surgical complication of this operation is post-pneumonectomy bronchial fistula (PPBF). Mortality in the development of this complication is high, there is no single approach to treatment. Goal. Studying the effectiveness of PPBF patients’ treatment with the combined method, comparing the results of such treatment with the results of PPBS treatment with other methods. Material and methods. A retrospective analysis of the results of conservative, conservative-endoscopic and combined PPBS treatment was carried out. Depending on the treatment method, patients were divided into three groups: patients treated with the conservative method (n=10), patients treated with the conservative-endoscopic method (n=9) and patients treated with the combined method (n=8). Findings. In the first group, mortality from PPBS with related complications was 70%, there were no fully recovered patients; in the second group, mortality from PPBS with related complications was 44.5%, and patients who recovered were 44.5%; in the third group, mortality directly from PPBS with complications associated with it was 0%; mortality from cancer progression during treatment of PPBS was 25%; the proportion of patients with fully healed PPBS was 87.5%; 75% of patients completed treatment. Conclusions. We believe that the use of the combined treatment method for PPBS gives real positive results, significantly reduces the mortality of patients if it is applied according to indications. With the application of this method, it is possible to treat patients after unsuccessful use of other treatment options for PPBS.

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