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Ann Thorac Surg 1998;65:807-809
© 1998 The Society of Thoracic Surgeons
Department of Surgery, University of Milan, San Giuseppe Hospital, Milan, Italy
Accepted for publication September 11, 1997.
Dr Varoli, Department of General Surgery, University of Milan, San Giuseppe Hospital FbF, Via San Vittore, 12, 20123 Milan, Italy.
Background. Bronchial fistula is one of the most serious complications of pulmonary resection.
Methods. We present an endoscopic treatment that consists of multiple submucosal injections of polidocanol–hydroxypoliethoxidodecane (Aethoxysklerol Kreussler) on the margins of the fistula using an endoscopic needle inserted through a flexible bronchoscope.
Results. From 1984 to 1995, 35 consecutive nonselected patients with a postresectional bronchopleural fistula were treated. All 23 partial postpneumonectomy or postlobectomy bronchopleural fistulas, ranging from 2 to 10 mm in diameter, healed completely. This did not occur in the 12 total bronchial dehiscences. No complications occurred due to the injection of the drug.
Conclusions. In our opinion this treatment can be considered a valid therapeutic approach, as it is simple, safe, scarcely traumatic, and inexpensive, particularly considering that, in patients in stable condition, it can be performed as an outpatient treatment.
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