Endoscopic Treatment of Postoperative Bronchopleural Fistula and Prolonged Air Leaks

Bronchopleural fistula and prolonged air leak are complications of pulmonary resectional surgery. The surgical procedures for the treatment of a large bronchopleural fistula with associated empyema may be disfiguring while that for the small one could be disabling. There are a subgroup of patients who may benefit from a minimally invasive endoscopic treatment approach. Nine patients were treated with endoscopic application of a fibrin sealant solution. Seven patients (77.7%) had favorable results with closure of the fistula. A mean of 1.85 procedures were required to achieve control of the leak. There were no procedure-related complications. All patients remained alive for the follow-up period without clinical or radiologic signs of recurrence.