Clinical evaluation of endoscopic bronchial closure of central airway-pleural fistulas with the atrial septal defect occluders: long-term follow-up_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

TAN Jianlong , CHEN Fengyu , OUYANG Bin , ZHANG Weidong , DENG Hongying , LI Rong , PENG Ran ,  LIU Zhiguang

Department of Respiratory Medicine, Hunan Provincial Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan 410005, P. R. China;

Corresponding author：

LIU Zhiguang, Email: liuzhiguang0404@163.com

Keywords：

Bronchopleural fistula; bronchoscopy; atrial septal defect occluder

DOI：

10.7507/1671-6205.202204024

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Objective To explore the safety and efficacy for patients with central airway-pleural fistula (APF) treated by atrial septal defect (ASD) occluder. Methods This was a retrospective study. Between January 2017 and October 2021, a total of 16 patients with postoperative APF were treated with ASD occluder through bronchoscope under local anesthesia combined with sedation. The efficacy and complication were recorded during and after the procedure. Results Sixteen patients were recruited in this study and the average age was 60.7 years (range 31 - 74 years). The main etiology for APF was lobectomy/segmentectomy (n=12), pneumonectomy (n=2), radical esophagectomy (n=1) or decortication for chronic empyema (n=1). Totally, 4 fistulas were located in right main bronchus, 3 in left main bronchus, 3 in right upper bronchus, 1 in right middle bronchus, 2 in right lower bronchus and 3 in left upper bronchus. The median diameter of APF was 7.8 mm (ranged from 4 to 18 mm) and the median diameter of ASD occluder inserted was 10.0 mm (ranged from 6 to 20 mm). Successful occlusion of APF was observed in 15 patients (15/16) and 1 patient died of multiple organ failure caused by bacteremia 14 days after the procedure. Fourteen patients were recruited for long-term follow-up, on a median follow-up period of 16.2 months (ranged from 3 to 46 months). There were 12 patients of complete remission and 2 patients of partial remission and only one patient took a second operation due to the enlargement of fistula and translocation of occluder. At follow-up, 4 patients died and the reasons were directly related to the primary etiology, and no patient died due to APF recurrence. Conclusion Endobronchial closure of central APF using ASD occluder is a minimally invasive but effective modality of treatment with satisfactory long-term outcome.

Citation： TAN Jianlong, CHEN Fengyu, OUYANG Bin, ZHANG Weidong, DENG Hongying, LI Rong, PENG Ran, LIU Zhiguang. Clinical evaluation of endoscopic bronchial closure of central airway-pleural fistulas with the atrial septal defect occluders: long-term follow-up. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(6): 403-407. doi: 10.7507/1671-6205.202204024 Copy

1.	Marques P, Andrade G, Granadas J, et al. Iatrogenic bronchopleural fistula. Cureus, 2020, 12(12): e12187.
2.	陈伟庄, 吴宏成. 获得性气道瘘的治疗进展. 现代实用医学, 2022, 34(1): 6-8,43.
3.	Nagahiro I, Aoe M, Sano Y, et al. Bronchopleural fistula after lobectomy for lung cancer. Asian Cardiovasc Thorac Ann, 2007, 15(1): 45-48.
4.	Motus IY, Bazhenov AV, Basyrov RT, et al. Endoscopic closure of a bronchopleural fistula after pneumonectomy with the Amplatzer occluder: a step forward? Interact Cardiovasc Thorac Surg, 2020, 30(2): 249-254.
5.	Scordamaglio PR, Tedde ML, Minamoto H, et al. Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results. J Bras Pneumol, 2009, 35(11): 1156-1160.
6.	北京健康促进会呼吸及肿瘤介入诊疗联盟专家委员会. 继发性气道–消化道瘘介入诊治专家共识. 中华肺部疾病杂志(电子版), 2018, 11(2): 131-138.
7.	劳妙婵, 高兴林, 李静, 等. 获得性呼吸道瘘的介入治疗进展. 中华结核和呼吸杂志, 2016, 39(3): 221-223.
8.	王湘奇, 黄海东, 张伟, 等. 不同类型先天性心脏病封堵器在支气管胸膜瘘中的应用. 中国呼吸与危重监护杂志, 2021, 20(1): 37-41.
9.	钟志成, 高兴林, 陈娉娉, 等. 经支气管镜置入房间隔封堵器治疗支气管胸膜瘘二例. 中华结核和呼吸杂志, 2018, 41(2): 153-155.
10.	Fruchter O, El Raouf BA, Abdel Rahman N, et al. Efficacy of bronchoscopic closure of a bronchopleural fistula with amplatzer devices: long-term follow-up. Respiration, 2014, 87(3): 227-233.
11.	刘家杰, 肖泽林, 高健齐, 等. 应用房间隔缺损封堵器封堵结核性支气管胸膜瘘的疗效分析. 岭南现代临床外科, 2020, 20(5): 582-587.
12.	Bai Y, Li YS, Chi J, et al. Endobronchial closure of the bronchopleural fistula with the ventricular septal defect occluder: a case series. BMC Pulm Med, 2021, 21(1): 313.
13.	胡轶, 尹雯, 张卫明, 等. 应用房/室间隔缺损封堵器治疗支气管胸膜瘘的临床疗效评价. 华中科技大学学报(医学版), 2019, 48(6): 690-694.
14.	周金花, 刘欢, 边翠霞, 等. 房间隔缺损封堵器治疗肺癌术后支气管胸膜瘘一例. 中国呼吸与危重监护杂志, 2021, 20(10): 741-742.

1. Marques P, Andrade G, Granadas J, et al. Iatrogenic bronchopleural fistula. Cureus, 2020, 12(12): e12187.
2. 陈伟庄, 吴宏成. 获得性气道瘘的治疗进展. 现代实用医学, 2022, 34(1): 6-8,43.
3. Nagahiro I, Aoe M, Sano Y, et al. Bronchopleural fistula after lobectomy for lung cancer. Asian Cardiovasc Thorac Ann, 2007, 15(1): 45-48.
4. Motus IY, Bazhenov AV, Basyrov RT, et al. Endoscopic closure of a bronchopleural fistula after pneumonectomy with the Amplatzer occluder: a step forward? Interact Cardiovasc Thorac Surg, 2020, 30(2): 249-254.
5. Scordamaglio PR, Tedde ML, Minamoto H, et al. Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results. J Bras Pneumol, 2009, 35(11): 1156-1160.
6. 北京健康促进会呼吸及肿瘤介入诊疗联盟专家委员会. 继发性气道–消化道瘘介入诊治专家共识. 中华肺部疾病杂志(电子版), 2018, 11(2): 131-138.
7. 劳妙婵, 高兴林, 李静, 等. 获得性呼吸道瘘的介入治疗进展. 中华结核和呼吸杂志, 2016, 39(3): 221-223.
8. 王湘奇, 黄海东, 张伟, 等. 不同类型先天性心脏病封堵器在支气管胸膜瘘中的应用. 中国呼吸与危重监护杂志, 2021, 20(1): 37-41.
9. 钟志成, 高兴林, 陈娉娉, 等. 经支气管镜置入房间隔封堵器治疗支气管胸膜瘘二例. 中华结核和呼吸杂志, 2018, 41(2): 153-155.
10. Fruchter O, El Raouf BA, Abdel Rahman N, et al. Efficacy of bronchoscopic closure of a bronchopleural fistula with amplatzer devices: long-term follow-up. Respiration, 2014, 87(3): 227-233.
11. 刘家杰, 肖泽林, 高健齐, 等. 应用房间隔缺损封堵器封堵结核性支气管胸膜瘘的疗效分析. 岭南现代临床外科, 2020, 20(5): 582-587.
12. Bai Y, Li YS, Chi J, et al. Endobronchial closure of the bronchopleural fistula with the ventricular septal defect occluder: a case series. BMC Pulm Med, 2021, 21(1): 313.
13. 胡轶, 尹雯, 张卫明, 等. 应用房/室间隔缺损封堵器治疗支气管胸膜瘘的临床疗效评价. 华中科技大学学报(医学版), 2019, 48(6): 690-694.
14. 周金花, 刘欢, 边翠霞, 等. 房间隔缺损封堵器治疗肺癌术后支气管胸膜瘘一例. 中国呼吸与危重监护杂志, 2021, 20(10): 741-742.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical evaluation of endoscopic bronchial closure of central airway-pleural fistulas with the atrial septal defect occluders: long-term follow-up

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