2019 Volume 41 Issue 1 Pages 46-50
Background. Bronchopleural fistula after lung resection for lung cancer is a highly morbid complication. The treatment of this complication remains a challenge for thoracic surgeons, and few reports have shown spontaneous recovery of a completely opened bronchopleural fistula with conservative therapy. Case. A 66-year-old man underwent a right lower lobectomy for primary lung cancer, which was detected during an examination for another disease. On the 23rd post-operative day, a bronchoscopy and chest drain air leak revealed a bronchopleural fistula, which was completely opened on the 36th day after the operation. On the 65th post-operative day, however, the bronchopleural fistula had spontaneously recovered due to appropriate thoracic drainage with the chest drainage tube placed directly under the fistula, anti-biotics therapy, plus nutrition. After the recovery of the bronchopleural fistula, a high negative pressure using a drainage tube-similar to vacuum-assisted-closure therapy-was used to achieve closure of the empyema cavity on the 80th post-operative day. Conclusion. Conservative therapy may be an effective strategy for bronchopleural fistula, especially in asymptomatic patients.
