The closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and Ⅰ stage or staged treatment for the left pyothorax
10.3760/cma.j.cn112434-20200309-00110
- VernacularTitle:右胸径路切割闭合器闭合左主支气管残端瘘并一期或分期治疗左脓胸
- Author:
Guangyu YANG
;
Lei XIAN
;
Chusheng HUANG
;
Tao LIU
;
Wen ZHAO
;
Xiangsen LIANG
;
Yu SUN
;
Shengzhuang YANG
;
Wenzhou LIU
;
Xiaohan BI
;
Feihai LIANG
;
Mengchen WANG
;
Yourong CHEN
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(3):145-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To review the experience of closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and I stage or staged treatment for the left pyothorax.Methods:6 patients with the left-main-bronchial stump fistula after left pneumonectomy combined with pyothorax were treated by closing the left-main-bronchial stump using endoscopic liner cutter staplers through the right thoracic approach, and pleura was used to cover the distal and proximal incisional margin of the stump respectively. The thoracic T-tube drainage was used in the I stage or staged treatment for the left pyothorax.Results:All patients were survived without recurrence of the bronchopleural fistula. 4 patients were observed to have no recurrence of pyothorax when 1 patient had recurrence of pyothorax and was treated with intermittent T-tube drainage.1 patient operated with left-thoracic fenestration in the past was treated with drainage waiting for secondary operation.Conclusion:The right thoracic approach seemed to be a safer and more effective method than the transsternal transpericardial approach in cases with the left-main-bronchial stump fistula combined with pyothorax. The use of endoscopic liner cutter staplers reduced the risk of bleeding, infection and recurrence of fistula. The T-tube drainage in the I stage or staged treatment for the left pyothorax was considered to be an easier way for treatment.
