Bronchoscopic Therapy for Bronchopleural Fistulas

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Abstract
Abstract: Persistent bronchopleural fistulas are associated with a high mortality rate and present difficult challenges for the chest physician. Initial management includes pleural space drainage with chest tube thoracostomy and intravenous antibiotic therapy. Although adequate drainage and control of infection are important aspects of effective therapy, these interventions are frequently not curative. Subsequent treatment will vary depending on the magnitude and duration of air leak, the underlying cause. and the patient's overall medical condition. Surgical closure of a persistent fistula coupled with pleural space obliteration is frequently considered for patients who are good surgical candidates, and successful fistula closure using bronchoscopic techniques has been reported over the past 20 years. Although this treatment modality has been used primarily in patients who are poor surgical candidates, bronchoscopic therapy has also been used as an adjunct to surgery or as sole therapy. This article discusses the role of bronchoscopic therapy in management of bronchopleural fistulas, and reviews the techniques, outcomes, and complications that have been reported in the English-based literature since 1970.

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