Tracheobronchial stenosis due to tuberculosis (TSTB) is a potentially debilitating complication of endobronchial tuberculosis (EBTB). Endobronchial interventions including silicone stent insertion is an acceptable approach to improve quality of life among patients with TSTB. However, little is known about the optimal management strategy for patients with bronchomalacia secondary to EBTB (B-EBTB) and whether stent-related complication rates are higher among this group of patients. Herein, we report two patients with B-EBTB who unfortunately developed bronchial tear related to silicone endobronchial stenting. Both patients were successfully managed conservatively without the need for emergency open surgery. We hypothesize that endobronchial intervention might be more beneficial for patients with pure TSTB and might be riskier in cases of bronchomalacia with reduced airway thickness and loss of airway cartilaginous support. More future studies are needed to bridge the current gap in knowledge regarding the optimal management and role of endobronchial interventions among patients with B-EBTB.
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http://dx.doi.org/10.1002/rcr2.684 | DOI Listing |
Respir Med Case Rep
October 2024
Department of Thoracic Surgery, Kochi Medical University, Kochi, Japan.
A male patient (age: 85 -years) with lung cancer underwent basal segmentectomy. Subsequently, he underwent emergency open window thoracotomy for a bronchial stump fistula. The general and nutritional conditions of the patient improved; nevertheless, natural closure of the fistula did not occur.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg Cases
February 2024
Department of General Thoracic Surgery, National Hospital Organization, Kanagawa Hospital, 666-1 Ochiai, Hadano, Kanagawa, 257-8585, Japan.
Background: There is no high level of evidence for the treatment of fistulous empyema. We report here a promising technique for closure of a bronchopleural fistula using costal cartilage as a bronchial embolus.
Case Presentation: The patient is a 79-year-old man.
BMC Pulm Med
June 2024
Department of Respiratory Medicine, Osaka Metropolitan University, 1-4-3, Asahimachi, Abeno-Ku, Osaka-City, Osaka, 545-8585, Japan.
Background: The management of intractable secondary pneumothorax poses a considerable challenge as it is often not indicated for surgery owing to the presence of underlying disease and poor general condition. While endobronchial occlusion has been employed as a non-surgical treatment for intractable secondary pneumothorax, its effectiveness is limited by the difficulty of locating the bronchus leading to the fistula using conventional techniques. This report details a case treated with endobronchial occlusion where the combined use of transbronchoscopic oxygen insufflation and a digital chest drainage system enabled location of the bronchus responsible for a prolonged air leak, leading to the successful treatment of intractable secondary pneumothorax.
View Article and Find Full Text PDFRespir Investig
May 2024
Department of Clinical Epidemiology and Health Economics School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Background: The endobronchial silicone spigot, also known as the endobronchial Watanabe spigot, is used in bronchoscopic interventions to manage prolonged pulmonary air leakage. However, the outcomes of this procedure have not been thoroughly investigated.
Methods: Using a Japanese national inpatient database from April 2014 to March 2022, we assessed the clinical characteristics and outcomes of all eligible patients who received the endobronchial spigot.
Sci Rep
January 2024
Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, College of Medicine, Seoul National University, Boramaero 5-Gil, Dongjakgu, Seoul, 07061, Republic of Korea.
Effective lung isolation prevents lung-to-lung aspiration during thoracotomy for the management of hemoptysis. Double-lumen endobronchial tubes (DLT) and bronchial blockers are commonly used for lung separation during thoracic surgery. In this study, the fluid-sealing characteristics of the endobronchial cuffs of three different commercially available DLTs (Broncho-Cath with a polyvinylchloride cuff, Broncho-Cath with a polyurethane cuff, and Human Broncho with a silicone cuff) and two different bronchial blockers (Arndt and Coopdech bronchial blockers) were evaluated using a benchtop model.
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