■据报道,栓塞线圈可有效治疗术后支气管胸膜瘘(BPF)。关于术后BPF的计算机断层扫描(CT)成像特征和可推式栓塞线圈的治疗程序,几乎没有详细信息。
■我们旨在说明术后BPFs的影像学特征,并介绍我们使用可推式栓塞线圈治疗它们的经验。
■6名连续患者(4名男性和2名女性,年龄在29-56岁之间)被诊断为术后BPF,接受可推式Nester®栓塞线圈的支气管镜治疗(CookMedical,布卢明顿,印第安纳州)被列入这个单一中心,回顾性研究。对多探测器CT扫描的多平面重建进行了审查,location,尺寸,和每个BPF的放射学并发症,包括空气收集,气胸,支气管扩张,和胸管。使用标准化的数据抽象表单,从这些患者的医疗档案中提取了人口统计学特征和临床结局.
■肺切除手术的基础疾病是肺结核(n=3),肺腺癌(n=2),肺曲霉病(n=1)。根据放射学发现,所有患者都用胸管收集空气或空气。多平面重建确定了所有患者术后BPF的存在。五个瘘管是中央的,位于主支气管或叶支气管的近端,当一个是外围的时候,远离肺叶支气管。瘘尺寸范围为0.8至5.8mm。随后的支气管镜检查和闭塞测试证实支气管残端有瘘管开口:右主支气管(n=1),右上叶(n=2),和左上叶(n=3)。基于血管成形术导管的手术可使用可推动的栓塞线圈实现“像三明治一样”的精确瘘管闭塞。5例BPF大小在0.8至1.5mm之间的患者用可推式栓塞线圈成功治疗,除了一个BPF大小为5.8毫米。随访期间未观察到不良事件或并发症。从29天到1,307天不等。
■可推动的Nester®栓塞线圈似乎是微创的,成本效益高,对于大小小于2mm的术后BPF,相对易于进行支气管镜治疗。需要进一步的研究以确保在术后BPF治疗中使用可推动的栓塞线圈。
UNASSIGNED: Embolization Coil has been reported to effectively treat postoperative bronchopleural fistula (BPF). Little detailed information was available on computer tomography (CT) imaging features of postoperative BPF and treating procedures with pushable Embolization Coil.
UNASSIGNED: We aimed to specify the imaging characteristics of postoperative BPFs and present our experience treating them with the pushable Embolization Coil.
UNASSIGNED: Six consecutive patients (four males and two females aged 29-56 years) diagnosed with postoperative BPF receiving bronchoscopic treatment with the pushable Nester® Embolization Coil (Cook Medical, Bloomington, Indiana) were included in this single-center, retrospective study. Multiplanar reconstruction of multidetector CT scans was reviewed for the presence, location, size, and radiological complications of each BPF, including air collection, pneumothorax, bronchiectasis, and chest tube. Using standardized data abstraction forms, demographic traits and clinical outcomes were extracted from the medical files of these patients.
UNASSIGNED: The underlying diseases for lung resection surgery were pulmonary tuberculosis (n = 3), lung adenocarcinoma (n = 2), and pulmonary aspergillosis (n = 1). All patients had air or air-fluid collection with chest tubes on radiological findings. Multiplanar reconstruction identified the presence of postoperative BPF in all patients. Five fistulas were central, located proximal to the main or lobar bronchus, while one was peripheral, distant from the lobar bronchus. Fistula sizes ranged from 0.8 to 5.8 mm. Subsequent bronchoscopy and occlusion testing confirmed fistula openings in the bronchial stump: right main bronchus (n = 1), right upper lobe (n = 2), and left upper lobe (n = 3). The angioplasty catheter-based procedure allows precise fistula occlusion \"like a sandwich\" with the pushable Embolization Coil. Five patients with BPF sizes ranging from 0.8 to 1.5 mm were successfully treated with a pushable Embolization Coil, except for one with a BPF size of 5.8 mm. No adverse events or complications were observed throughout follow-up, ranging from 29 to 1,307 days.
UNASSIGNED: The pushable Nester® Embolization Coil seems a minimally invasive, cost-effective, and relatively easy-to-perform bronchoscopic treatment for postoperative BPF with a size less than 2 mm. Further studies are required to ensure the use of pushable Embolization Coil in treating postoperative BPF.