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Bronchopleural Fistula--present-day Study Of An Old Problem. A Review Of 52 Cases.
Published 1971 · Medicine
Abstract A twelve-year experience (1957-1968) in the treatment of bronchopleural fistula is presented. During the study period 1,307 pulmonary resections were performed; in 35 patients (2.7%) a bronchopleural fistula developed. Pertinent etiological factors presented are: endobronchial tuberculous disease, preoperative positive sputum, drug-resistant organisms, contamination of the pleural space, concomitant illness, and surgical technique. The diagnosis was established clinically in most cases; chest roentgenograms, bronchoscopy, dye injections, bronchograms, and fistulograms were helpful. Chest roentgenograms were found to be the most productive investigative method for detecting fistula. Therapeutic measures by a medical team effort are stressed. Initially, the surgeon's primary role is to establish adequate chest drainage. Operative closure of a bronchopleural fistula may require multiple procedures. Of the patients operated on, 61.9% had their fistulas closed. The high incidence of bronchopleural fistula development among tuberculosis patients following pulmonary resection and the need to achieve a negative sputum before operation is stressed. The overall mortality in the series of bronchopleural fistula patients was 23.1%.