Cargando…

The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study

BACKGROUND: Pneumonectomy is a high-risk radical resection procedure, with bronchopleural fistula (BPF) being its most challenging and severe complication. This study aimed to assess the surgical risk factors and the impact of the bronchial stump closure technique on the incidence of the BPF. METHOD...

Descripción completa

Detalles Bibliográficos
Autores principales: Skrzypczak, Piotr, Roszak, Magdalena, Kasprzyk, Mariusz, Dyszkiewicz, Wojciech, Kamiński, Mikołaj, Gabryel, Piotr, Piwkowski, Cezary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562551/
https://www.ncbi.nlm.nih.gov/pubmed/36245618
http://dx.doi.org/10.21037/jtd-22-240
_version_ 1784808199881228288
author Skrzypczak, Piotr
Roszak, Magdalena
Kasprzyk, Mariusz
Dyszkiewicz, Wojciech
Kamiński, Mikołaj
Gabryel, Piotr
Piwkowski, Cezary
author_facet Skrzypczak, Piotr
Roszak, Magdalena
Kasprzyk, Mariusz
Dyszkiewicz, Wojciech
Kamiński, Mikołaj
Gabryel, Piotr
Piwkowski, Cezary
author_sort Skrzypczak, Piotr
collection PubMed
description BACKGROUND: Pneumonectomy is a high-risk radical resection procedure, with bronchopleural fistula (BPF) being its most challenging and severe complication. This study aimed to assess the surgical risk factors and the impact of the bronchial stump closure technique on the incidence of the BPF. METHODS: This is a single-center, cross-sectional study of the medical records of 455 post-pneumonectomy patients operated due to non-small cell lung cancer (NSCLC) in 2006–2017. We analyzed the following variables and their influence on the occurrence of the BPF: operation side, surgical techniques (i.e., manual suture or the stapler), stump buttressing, the extension of pneumonectomy, comorbidities, and postoperative complications. RESULTS: BPF occurred in 7.47% of post-pneumonectomy patients. BPF was more prevalent in right-sided pneumonectomy versus left-sided (10.98% vs. 5.32%; P=0.026). The use of a stapler or manual suture was not associated with the incidence of the BPF (7.96% vs.7.09%, P=0.72). There were no significant differences in the occurrence of BPF among bronchial stump buttressing with the parietal pleura (P=0.80), intercostal muscle flap (IMF) (P=0.46), and pericardial fat pad (P=0.88). When comparing data from 2006–2012 with those from 2013–2017, we found a steady decrease in the number of performed stump reinforcements, but this was not associated with a higher risk of BPF. CONCLUSIONS: The method used for stump closure, additional tissue buttressing of the bronchial stump and year of the surgery had no significant impact on the occurrence of BPF. Only right-sided pneumonectomy was associated with higher BPF occurrence.
format Online
Article
Text
id pubmed-9562551
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-95625512022-10-15 The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study Skrzypczak, Piotr Roszak, Magdalena Kasprzyk, Mariusz Dyszkiewicz, Wojciech Kamiński, Mikołaj Gabryel, Piotr Piwkowski, Cezary J Thorac Dis Original Article BACKGROUND: Pneumonectomy is a high-risk radical resection procedure, with bronchopleural fistula (BPF) being its most challenging and severe complication. This study aimed to assess the surgical risk factors and the impact of the bronchial stump closure technique on the incidence of the BPF. METHODS: This is a single-center, cross-sectional study of the medical records of 455 post-pneumonectomy patients operated due to non-small cell lung cancer (NSCLC) in 2006–2017. We analyzed the following variables and their influence on the occurrence of the BPF: operation side, surgical techniques (i.e., manual suture or the stapler), stump buttressing, the extension of pneumonectomy, comorbidities, and postoperative complications. RESULTS: BPF occurred in 7.47% of post-pneumonectomy patients. BPF was more prevalent in right-sided pneumonectomy versus left-sided (10.98% vs. 5.32%; P=0.026). The use of a stapler or manual suture was not associated with the incidence of the BPF (7.96% vs.7.09%, P=0.72). There were no significant differences in the occurrence of BPF among bronchial stump buttressing with the parietal pleura (P=0.80), intercostal muscle flap (IMF) (P=0.46), and pericardial fat pad (P=0.88). When comparing data from 2006–2012 with those from 2013–2017, we found a steady decrease in the number of performed stump reinforcements, but this was not associated with a higher risk of BPF. CONCLUSIONS: The method used for stump closure, additional tissue buttressing of the bronchial stump and year of the surgery had no significant impact on the occurrence of BPF. Only right-sided pneumonectomy was associated with higher BPF occurrence. AME Publishing Company 2022-09 /pmc/articles/PMC9562551/ /pubmed/36245618 http://dx.doi.org/10.21037/jtd-22-240 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Skrzypczak, Piotr
Roszak, Magdalena
Kasprzyk, Mariusz
Dyszkiewicz, Wojciech
Kamiński, Mikołaj
Gabryel, Piotr
Piwkowski, Cezary
The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title_full The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title_fullStr The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title_full_unstemmed The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title_short The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
title_sort technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer—a cross-sectional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562551/
https://www.ncbi.nlm.nih.gov/pubmed/36245618
http://dx.doi.org/10.21037/jtd-22-240
work_keys_str_mv AT skrzypczakpiotr thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT roszakmagdalena thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT kasprzykmariusz thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT dyszkiewiczwojciech thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT kaminskimikołaj thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT gabryelpiotr thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT piwkowskicezary thetechniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT skrzypczakpiotr techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT roszakmagdalena techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT kasprzykmariusz techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT dyszkiewiczwojciech techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT kaminskimikołaj techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT gabryelpiotr techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy
AT piwkowskicezary techniqueofstumpclosurehasnoimpactonpostpneumonectomybronchopleuralfistulainthenonsmallcelllungcanceracrosssectionalstudy