Is Endoscopic Treatment of Bronchopleural Fistula Useful?

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"tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "394" "paginaFinal" => "398" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gemma Mora, Alicia de Pablo, Cristina L. García-Gallo, Rosalía Laporta, Piedad Ussetti, Pablo Gámez, Mar Córdoba, Andrés Varela, María J. Ferreiro" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Gemma" "apellidos" => "Mora" "email" => array:1 [ 0 => "gemora24@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Alicia" "apellidos" => "de Pablo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Cristina L." "apellidos" => "García-Gallo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Rosalía" "apellidos" => "Laporta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Piedad" "apellidos" => "Ussetti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "Pablo" "apellidos" => "Gámez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 6 => array:3 [ "nombre" => "Mar" "apellidos" => "Córdoba" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 7 => array:3 [ "nombre" => "Andrés" "apellidos" => "Varela" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 8 => array:3 [ "nombre" => "María J." "apellidos" => "Ferreiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servieio de Neumología, Hospital Universitario Puerto de Hierro, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Torácica. Hospital Universitario Puerto de Hierro, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. G. Mora. Servico de Neumología. Hospital Universitario Puerta de Hierro. San Martín de Porres. 4. 28035 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-07-22" "fechaAceptado" => "2005-12-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154481" "palabras" => array:4 [ 0 => "Bronchial fistula" 1 => "Endoscopic treatment" 2 => "Fibrin sealants" 3 => "Histoacryl®" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154480" "palabras" => array:4 [ 0 => "Fístula bronquial" 1 => "Tratamiento endoscópico" 2 => "Sustancias sellantes" 3 => "Histoacryl" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "ObjectiveNew endoscopic techniques have been developed as an alternative to surgical treatment of bronchopleural fistula. The objective of this study was to analyze our experience with endoscopic treatment of such fistulas. Material and methodsWe conducted a retrospective study of patients with bronchopleural fistula diagnosed by fiberoptic bronchoscopy. Patient characteristics, underlying disease, fistula size, and outcome of endoscopic treatment were analyzed. The endoscopic technique consisted of injection of fibrin sealants (Histoacryl® and/or Tissucol®) through the catheter of the fiberoptic bronchoscope. ResultsBetween 1997 and 2004, 18 patients were diagnosed with bronchopleural fistula by fiberoptic bronchoscopy. AH were men with a mean (SD) age of 62 (12) years. Bronchopleural fistula was diagnosed after neoplastic surgery in 16 patients, in the bronchial suture after lung transplantation in 1 patient, and concurrently with pleural effusion due to hydatidosis in the remaining patient. The size of the fistula ranged from 1 mm to 10 mm (mean 3.6 [2.7] mm). Fibrin sealants were applied in 14 patients, 2 underwent direct surgery after diagnosis, and the bronchopleural fistula closed spontaneously in the remaining 2. The fibrin sealant used was Histoacryl® in 12 patients and Tissucol® in 2. Pleural drainage was employed simultaneously and antibiotic therapy was administered at the discretion of the surgeon. The 4 patients whose bronchopleural fistula was associated with empyema also underwent pleural lavage. In 12 patients the fistulas closed as a result of the endoscopic technique (85.7%), and no complications were observed. For 85.7%, fewer than 3 applications of fibrin sealant were necessary. ConclusionsThe success rate of closure of bronchopleural fistula with fibrin sealants injected under guidance with fiberoptic bronchoscopy is high and there are no complications. This technique can render surgery unnecessary." ] "es" => array:1 [ "resumen" => "ObjetivoSe han desarrollado nuevas técnicas endoscópicas como alternative al tratamiento quirúrgico de las fístulas bronquiales (FB). El objetivo de nuestro trabajo ha sido analizar nuestra experiencia en el tratamiento endoscópico de las FB. Material y métodosHemos realizado un estudio retrospective de los pacientes con FB diagnosticados por fibrobroncoscopia analizando sus características, enfermedad causal de la fístula, tamaño y resultados del tratamiento endoscópico. La técnica endoscópica consistió en la instilación mediante catéter a través del fibrobroncoscopio de sustancias sellantes (SS) (Histoacryl® y/o Tissucol®). ResultadosEntre 1997 y 2004 diagnosticamos 18 FB a través de fibrobroncoscopia, todas ellas en varones con una edad media (± desviación estándar) de 62 ± 12 aνos. En 16 pacientes la FB se produjo tras cirugía de neoplasia, en uno apareció en la sutura bronquial de un trasplante pulmonar y en otro fue simultánea a un derrame pleural por hidatidosis. El tamaño oscilo entre 1 y 10 mm (media de 3,6 ± 2,7 mm). Aplicamos SS en 14 pacientes, en 2 se realizó cirugiá directamente tras el diagnóstico y en otros 2 la FB cerró espontáneamente. Las SS utilizadas fueron Histoacryl® en 12 pacientes y Tissucol® en otros 2. Simultáneamente se empleó drenaje pleural y antibioterapia sistémica según criterio del cirujano. En los 4 casos donde la FB estaba asociada a empiema se aplicaron además lavados pleurales.La técnica endoscópica cerró la FB en 12 pacientes (85,7%) sin complicaciones asociadas. En el 85,7% fueron necesarias nienos de 3 aplicaciones de SS. ConclusionesLa utilización de SS, mediante técnicas de fibrobroncoscopia, permite el cierre de las FB con un alto porcentaje de éxito, un número reducido de aplicaciones y nula morbilidad, evitando la cirugía de la fistula." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Empyema and bronchopleural fistula after pneumonectomy: factors affecting incidence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C Deschamps" 1 => "A Bernard" 2 => "FC Nichols III" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2001" "volumen" => "72" "paginaInicial" => "243" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => 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