Right Lower Lobe B
Right Lower Lobe Bronchopleural Fistula Treated with a Novel, Y-shaped, Single-Plugged, Covered, Metallic Airway Stent
Gang Wu1, Zong-Ming Li1, Jia-Xiang Wang2*, Xin-Wei Han1, De-Chao Jiao1, Ming Zhu1, Ke-Wei Ren1
1: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
2: Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
*Corresponding author: Jia-Xiang Wang, Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; E-mail: [email protected]. Tel: +8613938570175; Fax: +86037166862172
Abstract: Background: Right lower lobe bronchopleural fistula is an infrequent but life-threatening complication after lobectomy. It serious influence patients quality of life. Purpose: To determine the feasibility and efficacy of using Y-shaped, single-plugged, covered, metallic stents to treat right lower lobe bronchopleural fistula. Material and methods: We designed the Y-shaped, single-plugged, covered, self-expandable, metallic airway stent to fit the specific anatomy of the right lower lobe bronchus. The stent had a main tube and two branches, resembling an inverted “Y.” One of the branches was closed (plugged) and bullet-shaped; the other was tubular and open. The entire stent was encased in a nitinol wire mesh. Stent size was individualized using Multi-Slice Spiral Computed Tomography (MSCT) measurements of the airway. Under fluoroscopic guidance, we implanted 10 Y-shaped stents in 10 patients who had right lower lobe bronchopleural fistula. Results: Stent insertion was successful in all patients. All fistulas were successfully closed immediately after stent placement. Follow-up was performed for 2–6 months. Positive clinical outcomes were seen in 9 of 10 patients. One patients died of intractable pulmonary infection and multiorgan failure. The fistula completely healed and the stent could be removed in seven patients; however, two of them were left with a small, aseptic, residual right lower lung cavity. Conclusion: The placement of Y-shaped, single-plugged, covered, self-expandable metallic airway stents seems to be a feasible and safe method for the treatment of bronchopleural fistulas involving the right lower lobe bronchus. This stent is a promising therapeutic alternative for bronchopleural fistulas involving the right lower lobe bronchus.
[Gang Wu, Zong-Ming Li, Jia-Xiang Wang, Xin-Wei Han, De-Chao Jiao, Ming Zhu, Ke-Wei Ren. Right Lower Lobe Bronchopleural Fistula Treated with a Novel, Y-shaped, Single-Plugged, Covered, Metallic Airway Stent. Life Sci J. 2013; 10(1):674-678] (ISSN: 1097-8135). http://www.lifesciencesite.com.
Key words: Right lower lobe bronchus; bronchopleural fistula; stent; single plugged; Y-shaped; interventional radiology.
