A Case of Bronchial Stump Fistula Successfully Treated by Bronchial Intervention with Polyglycolic Acid Sheet and Fibrin Glue Using a Combination of Bronchoscopy and Thoracoscopic Surgery

• Published in: The Journal of the Japan Society for Respiratory Endoscopy Vol. 44; no. 2; pp. 147 - 152
• Main Authors: Kameda, Yohei, Yamamoto, Taketsugu, Shigeta, Naoko, Kawahara, Mitsue, Sugawara, Kai, Abe, Hinako, Suzukawa, Yuichiro, Osada, Reko, Hirose, Tomofumi, Maehara, Takamitsu
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Respiratory Endoscopy 25.03.2022
• Subjects: Bronchial stump fistula; Bronchoscopy; Fibrin glue; Polyglycolic acid sheet (PGA sheet); Thoracoscopic surgery
• ISSN: 0287-2137; 2186-0149
• DOI: 10.18907/jjsre.44.2_147

Background. Bronchial stump fistula is a serious complication after lung resection and often difficult to treat. Recently, various bronchoscopic interventions and their effectiveness have been reported. Case. An 85-year-old man developed pyothorax after right upper lobectomy. Bronchoscopy showed a bronchial fistula in the right upper bronchial stump. We attempted endoscopic bronchial occlusion with a polyglycolic acid (PGA) sheet and fibrin glue, but it was ineffective. Later, we retried endoscopic bronchial occlusion with a PGA sheet and fibrin glue using a combination of bronchoscopy and thoracoscopic surgery. While observing the inside of the cavity with a thoracoscope, the sheet was placed in an appropriate position. After that, the air-leakage stopped and the pyothorax improved. Conclusion. Bronchial intervention with a PGA sheet and fibrin glue is a simple and useful treatment, and combining of bronchoscopy and thoracoscopic surgery is considered effective for ensuring the success of this procedure.