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Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report

BACKGROUND: Bronchial fistula is a severe complication of pneumonectomy with a high mortality rate. We previously reported a technique for bronchial closure to prevent bronchial fistula in a canine model. We described that mucosal ablation could result in primary wound healing and involve mucosal ti...

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Autores principales: Makidono, Kimitaka, Miyata, Yoshihiro, Ikeda, Takuhiro, Tsutani, Yasuhiro, Kai, Yuichiro, Kushitani, Kei, Takeshima, Yukio, Okada, Morihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890849/
https://www.ncbi.nlm.nih.gov/pubmed/33596992
http://dx.doi.org/10.1186/s13256-020-02652-x
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author Makidono, Kimitaka
Miyata, Yoshihiro
Ikeda, Takuhiro
Tsutani, Yasuhiro
Kai, Yuichiro
Kushitani, Kei
Takeshima, Yukio
Okada, Morihito
author_facet Makidono, Kimitaka
Miyata, Yoshihiro
Ikeda, Takuhiro
Tsutani, Yasuhiro
Kai, Yuichiro
Kushitani, Kei
Takeshima, Yukio
Okada, Morihito
author_sort Makidono, Kimitaka
collection PubMed
description BACKGROUND: Bronchial fistula is a severe complication of pneumonectomy with a high mortality rate. We previously reported a technique for bronchial closure to prevent bronchial fistula in a canine model. We described that mucosal ablation could result in primary wound healing and involve mucosal tight adhesions histologically. In this paper, the pathologic findings of one patient, who underwent autopsy 4 years after surgery, were reviewed. CASE PRESENTATION: A 70-year-old Japanese man was diagnosed with malignant pleural mesothelioma and underwent right extra-pleural pneumonectomy. The right main bronchus was cut using a scalpel. When closing the bronchial stump, the bronchial mucosa was ablated by electric cautery and sutured manually using 3-0 absorbable sutures. The bronchial fistula was not found after pneumonectomy. Four years after surgery, the patient died of recurrent malignant pleural mesothelioma and underwent autopsy. Macroscopic evaluation showed tight adhesions and white scars on the bronchial stump. Microscopic findings showed few inflammatory cells and α-smooth muscle actin (α-SMA)-positive cells. CONCLUSIONS: The results from this case suggested that bronchial mucosal ablation leads to robust agglutination of bronchial stump over years. This technique is not only simple but also reliable to prevent bronchial fistula.
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spelling pubmed-78908492021-02-22 Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report Makidono, Kimitaka Miyata, Yoshihiro Ikeda, Takuhiro Tsutani, Yasuhiro Kai, Yuichiro Kushitani, Kei Takeshima, Yukio Okada, Morihito J Med Case Rep Case Report BACKGROUND: Bronchial fistula is a severe complication of pneumonectomy with a high mortality rate. We previously reported a technique for bronchial closure to prevent bronchial fistula in a canine model. We described that mucosal ablation could result in primary wound healing and involve mucosal tight adhesions histologically. In this paper, the pathologic findings of one patient, who underwent autopsy 4 years after surgery, were reviewed. CASE PRESENTATION: A 70-year-old Japanese man was diagnosed with malignant pleural mesothelioma and underwent right extra-pleural pneumonectomy. The right main bronchus was cut using a scalpel. When closing the bronchial stump, the bronchial mucosa was ablated by electric cautery and sutured manually using 3-0 absorbable sutures. The bronchial fistula was not found after pneumonectomy. Four years after surgery, the patient died of recurrent malignant pleural mesothelioma and underwent autopsy. Macroscopic evaluation showed tight adhesions and white scars on the bronchial stump. Microscopic findings showed few inflammatory cells and α-smooth muscle actin (α-SMA)-positive cells. CONCLUSIONS: The results from this case suggested that bronchial mucosal ablation leads to robust agglutination of bronchial stump over years. This technique is not only simple but also reliable to prevent bronchial fistula. BioMed Central 2021-02-18 /pmc/articles/PMC7890849/ /pubmed/33596992 http://dx.doi.org/10.1186/s13256-020-02652-x Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Makidono, Kimitaka
Miyata, Yoshihiro
Ikeda, Takuhiro
Tsutani, Yasuhiro
Kai, Yuichiro
Kushitani, Kei
Takeshima, Yukio
Okada, Morihito
Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title_full Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title_fullStr Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title_full_unstemmed Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title_short Bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
title_sort bronchial mucosal ablation for bronchial stump closure in right pneumonectomy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890849/
https://www.ncbi.nlm.nih.gov/pubmed/33596992
http://dx.doi.org/10.1186/s13256-020-02652-x
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