# Retrospective Study of Bronchoscopic Intervention Therapy for Bronchopleural Fistula Induced by Pulmonary Surgery

## TL;DR

This study evaluates the effectiveness of bronchoscopic intervention in treating bronchopleural fistulas caused by lung surgery, showing high success rates and improved patient outcomes.

## Contribution

The study provides clinical evidence for bronchoscopic intervention as an effective treatment for post-surgical bronchopleural fistulas.

## Key findings

- Right lung fistulas were more common than left lung fistulas, with the right lower lobe being the most frequent site.
- Bronchoscopic intervention significantly improved KPS scores and reduced symptoms like dyspnea and drainage volume.
- The overall effective rate of the treatment was 90.6%, with a median survival time of 21 months.

## Abstract

气管镜介入技术作为近年来发展的新技术，具有创伤小、安全性高及可重复性的优点。本研究旨在探讨肺部恶性肿瘤和良性疾病手术后发生的支气管胸膜瘘（bronchopleural fistula, BPF）的临床特征和气管镜下介入治疗的临床疗效，为BPF的防治提供参考方法。

收集2020年6月至2023年9月北京中医药大学东直门医院呼吸病中心诊治的BPF患者64例，总结BPF发生部位及瘘口特点，并采用气管镜介入治疗。对瘘口较小者（≤5 mm）进行黏膜下注射聚桂醇及氰基丙烯酸异丁酯、医用生物蛋白胶或硅胶假体封堵相结合治疗；对瘘口较大者（>5 mm）分别置入不同类型的气道金属覆膜支架和心脏封堵器；观察术前、术后的卡氏体能状态（Karnofsky performance status, KPS）评分、气促评分（shortbreath scale, SS）、体温、胸腔引流液量和白细胞计数。

64例患者实施全肺、肺叶或肺段切除96个，发生瘘的部位65处，瘘口74个；右肺瘘口数量（63.5%）明显多于左侧（36.5%），且右下叶支气管瘘最为常见（40.5%）。术后患者的KPS评分明显升高，而SS评分、体温、胸腔引流液量和白细胞计数明显降低，与术前比较均有统计学差异（P<0.05）。电话或住院随访1-38个月，中位生存时间为21个月。完全缓解33例（51.6%），临床完全缓解7例（10.9%），部分缓解18例（28.1%），无效6例（9.4%），总有效率为90.6%。

肺部手术后发生的BPF临床症状较严重，常危及生命，气管镜下介入治疗BPF是一种快速有效的治疗方法。

Evaluation criteria of curative effect

Analysis for fistula site induced by lung surgery

Analysis for the efficacy of interventional therapy

The efficacy of interventional therapy for different fistulas