Background: This study aims to compare the results of the open
surgical approach versus endobronchial conical stent application in
the treatment of extensive fistulas.
Methods: Between December 2004 and April 2016, a total
of 36 patients (34 males, 2 females; mean age 59.6±8.1 years;
range, 40 to 72 years) with a bronchopleural fistula of ≥8 mm in
diameter and underwent either conventional open surgery with
stump-supported intercostal muscle flap or endobronchial ultra-flex
expandable stenting were retrospectively analyzed. The demographic
and clinical characteristics of the patients, operative data including
the length of hospital stay, thoracic drainage time, and early
mortality, and survival data were recorded.
Results: The mean hospitalization time was 17.4±4.5 days for the
bronchoscopic group and 22.5±6.7 days for the invasive surgery
group (p=0.026). The median time to removal of thoracic drains
was 15 (range, 10 to 30) days for the bronchoscopic group and
26 (range, 14 to 55) days for the surgical group (p=0.027).
Early mortality rates of both approaches were in favor of the
bronchoscopic approach (χ2
=7.058; p=0.008). Two-year survival rate
was 76.47% (n=13) in the bronchoscopic group and 70% (n=7) in the
surgical group. There was no statistically significant difference in
the survival rates between the two groups (χ2
Conclusion: Our study results suggest that bronchoscopic approach
can be the first choice in the treatment algorithm of fistulas with a
diameter of ≥8 mm presenting with empyema in selected cases.
Keywords: Bronchopleural fistula, conic stent, pneumonectomy, rigid