EXPERIENCE OF TREATMENT OF FISTULA OF RIGHT MAIN BRONCHUS STUMP WITH THE USE OF VASCULAR OCCLUDER

Abstract

Goal: to close the fistula of right main bronchus stump with the use of the vascular occluder of ASD. The clinical case is described. Materials and methods. The fistula of right main bronchus, developed after final pulmonectomy on the right performed due to emergency indications caused fibrous cavernous tuberculosis, complicated by pulmonary hemorrhage, was closed by ASD occluder with 8 mm diameter, relevant to the diameter of bronchopleural fistula. Empyema space was first of all sanitated through thoracostoma, the volume of right hemithorax was reduced due preceding seven-costal posterosuperior thoracoplasty. The intervention was done under local anesthesia with double monitoring from tracheal lumen by bronchoscope and from thoracostoma space. The intervention lasted for 20 minutes. Results. Air discharge stopped immediately after the installation of the occluder. The patient demonstrated significant improvement of respiration and voicing even without pleural space plugging. In the follow-up period in 12 months the occluder was covered by epithelium fully stopping the air inflow from bronchus into pleural space. Management of bronchial fistula with ASD occluder is a fast, safe and effective intervention.

Keywords

• туберкулез
• осложнения пульмонэктомии
• свищ культи главного бронха
• сосудистый окклюдер