# Bronchoscopic management of bronchopleural fistula using free fat pad transplant with platelet-rich plasma: a case study

## TL;DR

This case study presents a successful bronchoscopic treatment for a bronchopleural fistula using fat pad transplants and platelet-rich plasma.

## Contribution

The paper introduces a novel bronchoscopic technique combining free fat pad transplant and platelet-rich plasma for BPF management.

## Key findings

- The bronchoscopic intervention successfully addressed a post-lobectomy bronchopleural fistula.
- The use of fat pads and platelet-rich plasma showed promise in sealing the fistula and promoting healing.
- The technique may offer improved outcomes compared to traditional surgical or bronchoscopic methods.

## Abstract

A bronchopleural fistula (BPF) occurs when an abnormal connection forms between the bronchial tubes and pleural cavity, often due to surgery, infection, trauma, radiation, or chemotherapy. The outcomes of both surgical and bronchoscopic treatments frequently prove to be unsatisfactory.

Here, we report a case of successful bronchoscopic free fat pad transplantation combined with platelet-rich plasma, effectively addressing a post-lobectomy BPF. Contrast-enhanced chest tomography revealed pleural thickening with heterogeneous consolidations over the right upper and middle lobes, indicative of destructive lung damage and bronchiectasis. The patient underwent thoracoscopic bilobectomy of the lungs. During surgery, severe adhesions and calcification of the chest wall and lung parenchyma were observed. The entire hilar structure was calcified, presenting challenges for dissection, despite the assistance of energy devices. Bronchoscopic intervention was required, during which two abdominal subcutaneous fat pads were retrieved.

This innovative approach offers promise in the management of BPF and signals potential advancements in enhancing treatment efficacy and patient recovery.