HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kiriyama, M. Articles by Sasaki, H. Search for Related Content PubMed PubMed Citation Articles by Kiriyama, M. Articles by Sasaki, H. Related Collections Related Article

Ann Thorac Surg 2002;73:945-948
© 2002 The Society of Thoracic Surgeons

---

Original article: general thoracic

Endobronchial neodymium:yttrium-aluminum garnet laser for noninvasive closure of small proximal bronchopleural fistula after lung resection

^a Department of Surgery II, Nagoya City University Medical School, Nagoya City, Japan

Accepted for publication October 18, 2001.

* Address reprint requests to Dr Kiriyama, Department of Surgery II, Nagoya City University Medical School, 1, Kawasumi, Mizuho, Nagoya, 467-8601, Japan
e-mail: m.kiri{at}med.nagoya-cu.ac.jp

Background. Bronchopleural fistula (BPF) is a serious complication of lung resection. The management of persistent BPF is one of the most complex challenges encountered by thoracic surgeons.

Methods. We used neodymium:yttrium-aluminum garnet (Nd:YAG) laser in 8 patients with BPF who were treated at our hospital, between January 1991 and December 1997. Through the flexible fiberoptic bronchoscope, Nd:YAG laser beam was directed to the bronchial mucosa surrounding the BPF. One-half–second energy pulses of 8 to 20 W were used. Close follow-up of successful patients showed complete closure of the BPF without further treatment.

Results. The procedure was successful in 4 of 5 patients who had no infection or tumor at the bronchial stump. However, the procedure failed in 3 other patients, who had residual tumor or infection by aspergillus at the stump.

Conclusions. Closure of small BPF by laser seems to be due to edema and to an inflammatory reaction of the bronchial mucosa surrounding the BPF. If the diagnosis of small proximal BPF is made in the absence of tumor or infection, Nd:YAG laser offers an option for endobronchial treatment of small (<2 mm) BPF. If this technique is successful, it avoids the morbidity associated with more invasive surgical procedures.

Related Article

Invited commentary

Douglas E. Wood
Ann. Thorac. Surg. 2002 73: 948-949. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				G. Stratakos, L. Zuccatosta, I. Porfyridis, M. Sediari, C. Zisis, V. Mariatou, E. Kostopoulos, A. Psevdi, S. Zakynthinos, and S. Gasparini Silver nitrate through flexible bronchoscope in the treatment of bronchopleural fistulae. J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 603 - 607. [Abstract] [Full Text] [PDF]

				J. Zhang, S. Hu, B. Gao, D. Liu, F. Song, B. Li, Y. Yang, S. Zhu, and Z. Wang Interventional closure of postpneumonectomy bronchial pleural fistula with a self-expandable double umbrella shaped occluder knitted with nitinol shape memory alloy J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 531 - 533. [Full Text] [PDF]

				D. West, A. Togo, and A. J.B. Kirk Are bronchoscopic approaches to post-pneumonectomy bronchopleural fistula an effective alternative to repeat thoracotomy? Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 547 - 550. [Abstract] [Full Text] [PDF]