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Fistules bronchiques après une pneumonectomie pour cancer thoracique: incidence, gravité et facteurs de risque
| Content Provider | Semantic Scholar |
|---|---|
| Author | Yena, Sadio Doddoli, Christophe Aragon, Adrian Mondini, M. Thomas, Pascal André Giudicelli, Roger |
| Copyright Year | 2007 |
| Abstract | Bronchial fi stula after pneumonectomy for thoracic malignancies: incidence, severity, and risk factors Objectives : To assess the incidence, severity and risk factors of bronchial fi stula following pneumonectomy for cancer. Patients and methods: From 1989 to 2003, 690 consecutive patients underwent a pneumonectomy for cancer. The M/F sex ratio was 5,44. Mean age was 59+/-9,9 years [16 ‐ 81]. Clinical variables (age, sex), functional data (FEV1, FEV1/VC), comorbidities (tobacco consumption, COPD, diabetes mellitus), treatment characteristics (induction therapy, previous thoracic surgery, side of the resection, reinforcement of the bronchial stump), pathological fi ndings (histology, TNM staging) were studied retrospectively, and their possible association with the occurrence of a bronchial fi stula was assessed by univariate and multivariate analysis. Results: Fifty one patients (7,4%) experienced a bronchial fi stula. This complication accounted for 56% (45/80) of the cases of reoperation and 25,5% (13/51) of early deaths. At univariate analysis, the following factors were identifi ed as statistically signifi cant: tobacco consumption (p=0,003), presence of COPD (p =0,02), preoperative radiotherapy (p=0,027), previous thoracic surgery (p=0,03), right side of the resection (p<0,001), hand-fashioned bronchial suture (p=0,05) and squamous cell histology (p= 0,038). Multivariate logistic regression analysis disclosed tobacco consumption (p=0,002), presence of COPD (p=0,01), previous thoracic surgery (p=0,03), extended procedures (p=0,048), right pneumonectomy (p<0,001) and squamous cell histology (p=0,02) as independent predictors of bronchial fi stula. Conclusion: The occurrence of a bronchial fi stula following pneumonectomy is a frequent life threatening event, especially in cases of right sided resections and extended procedures. Tobacco cessation, preoperative rehabilitation, and reinforcement of the bronchial suture are possible means of prevention. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://sfctcv.fr/ftp/journal/jo_2007_1_05_r.pdf |
| Alternate Webpage(s) | http://www.sfctcv.net/ftp/journal/jo_2007_1_05.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
