Silver nitrate through flexible bronchoscope in the treatment of bronchopleural fistulae

التفاصيل البيبلوغرافية
العنوان: Silver nitrate through flexible bronchoscope in the treatment of bronchopleural fistulae
المؤلفون: Vasso Mariatou, Stefano Gasparini, Eleftherios Kostopoulos, Grigoris Stratakos, Lina Zuccatosta, Charalambos Zisis, Argini Psevdi, Michele Sediari, Spyros Zakynthinos, Ilias Porfyridis
المصدر: The Journal of Thoracic and Cardiovascular Surgery. 138(3):603-607
بيانات النشر: Elsevier BV, 2009.
سنة النشر: 2009
مصطلحات موضوعية: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Endoscope, Fistula, medicine.medical_treatment, Bronchopleural fistula, Drug Administration Schedule, chemistry.chemical_compound, Pneumonectomy, Bronchoscopy, Recurrence, medicine, Humans, Flexible bronchoscopy, Aged, medicine.diagnostic_test, business.industry, Middle Aged, Pleural Diseases, medicine.disease, Bronchial Fistula, Surgery, Silver nitrate, Treatment Outcome, chemistry, Silver Nitrate, business, Cardiology and Cardiovascular Medicine, Follow-Up Studies
الوصف: Objective Bronchopleural fistula is a severe complication after pneumonectomy or lobectomy. Local application of silver nitrate to seal bronchopleural fistulae was reported once 25 years ago with considerable success but was never repeated. We aimed to develop and evaluate a concrete technique of applying silver nitrate through a flexible bronchoscope to treat bronchopleural fistulae in central airways. Methods Consecutive patients with small (≤5 mm) bronchopleural fistulae in proximal airways were included in the study. After measurement of bronchopleural fistula size through a flexible videobronchoscopy, a standard bronchoscopic cytology brush covered with silver nitrate was passed through the working channel of the scope and was rubbed against the fistula's orifice producing blanching and edema on the mucosa. This procedure was repeated until closure of the fistula's orifice (treatment success) or absence of any tissue response after 2 bronchoscopic sessions (treatment failure). Results Of 16 patients referred, 5 were excluded from treatment because of large (>5 mm) fistulae. Among the 11 treated patients (median fistula diameter 3 mm, range 2–5 mm), treatment failure was observed in 2 patients in whom treatment was attempted early (15 days postsurgery). In the remaining 9 patients, treatment success was achieved (81.8% success rate) after a median of 2.5 (range 1–10) applications of silver nitrate. After 11 (0.5–24) months of follow-up, no relapse was observed among successfully treated fistulae. Conclusion The local application of silver nitrate through a flexible bronchoscopic brush produced a burn and healing process on the mucosa of small bronchopleural fistulae of the central airways, leading to effective and lasting treatment in most cases.
تدمد: 0022-5223
DOI: 10.1016/j.jtcvs.2008.10.054
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ff0ceb29fa847df8ecc973bb321bba23
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....ff0ceb29fa847df8ecc973bb321bba23
قاعدة البيانات: OpenAIRE
الوصف
تدمد:00225223
DOI:10.1016/j.jtcvs.2008.10.054