Introduction Patients with post-operative bronchopleural fistula (BPF) traditionally have surgical treatment via thoracotomy, but this carries significant morbidity and mortality. Our group has previously described the use of albumin-glutaraldehyde tissue adhesive (BioGlue® ) to close BPFs (Ranu et al Ann Thorac Surg 2009;88:1691-1692). We provide the follow-up on our experience thus far. Methods Five patients (3 male, mean age 61 years) developed BPFs. Initial surgical procedures were: left pneumonectomy in 3 (bronchiectasis with MAI; fibrous tumour; aspergilloma), right lower lobectomy (bronchiectasis) and right middle/lower lobectomy (cancer). Two patients had the procedure twice (fibrous tumour) due to recurrence of the BPF. All had BioGlue® applied under direct vision via the rigid bronchoscope as previously described (Ranu et al ERJ 2009 suppl E309). Results The BPFs sealed with BioGlue® for all patients. One patient developed recurrent BPF at day 11, which was again sealed with BioGlue® , but he remained on mechanical ventilation and died from an unrelated cause 18 days later. The other recurrence occurred at 10 weeks and that patient had another application of BioGlue® and remains well. Of the 3 with no recurrence, they remain well at 16, 14 and 3 months post procedure. Those with recurrence did not have any evidence of granulation tissue or other endobronchial scarring due to BioGlue® . Conclusion BioGlue® can be safely used to seal small BPFs and the medium term follow-up (upto 16 months) data indicates that this treatment is successful. There is no evidence of harmful effects from BioGlue® in our patient group.
Full conference title:
20th European Respiratory Society conference
- ERS 20th (2010)