Risk factors for bronchopleural complications after pneumonectomy

Giller DB, Giller BM, Giller BD, et al. . Risk factors for bronchopleural complications after pneumonectomy. Pirogov Russian Journal of Surgery. 2025;(3):7‑15. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia20250317

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To assess various risk factors for bronchopleural complications, as well as effectiveness of some techniques for bronchial stump closure and covering.

MATERIAL AND METHODS

We studied the results of 2022 pneumonectomies between 1958 and 2023. Different techniques for bronchial stump closure and covering were used. We studied the influence of the following factors on the incidence of bronchial fistula: pulmonary disease; pulmonary lesion complicated by bleeding, empyema; acute progression of tuberculosis as caseous pneumonia; Mycobacterium tuberculosis with multiple and extensive drug resistance; tuberculosis of the main bronchus; preoperative destructive tuberculosis-related lesion of contralateral lung; pulmonary gangrene; partial resection of cancer; extended bilateral lymph node dissection, etc.

RESULTS

The incidence of bronchopleural complications and mortality significantly decreased over time. Nevertheless, these events remained the main cause of death after pneumonectomy until the last decade. Most often, death following bronchopleural complications was noted in patients with bronchial fistula within 21 days. Among 111 patients with this complication, 48 (43.24%) ones died.

CONCLUSION

According to our data, bronchial suturing technique and side of surgery are the most significant factors regarding the incidence of bronchial fistula. The highest risk is associated with surgery for pulmonary gangrene, the lowest risk — with total resection of cancer. The incidence of delayed bronchial fistula in tuberculosis exceeds the incidence of early bronchial fistula.

Keywords:

pneumonectomy

bronchopleural complications

bronchial fistula

lateral thoracotomy

VATS

Authors:

Giller D.B.

Sechenov First Moscow State Medical University;
Medicine JSC;
Moscow Regional Clinical Tuberculosis Dispensary

ORCID: 0000-0001-9159-0023

Giller B.M.

Chelyabinsk Regional Clinical Tuberculosis Dispensary

Giller B.D.

Sechenov First Moscow State Medical University

Smerdin S.V.

State Budgetary Institution of Moscow Region «Moscow Regional Clinical Anti-Tuberculosis Dispensary»

ORCID: 0000-0002-2602-214X

Ergeshov A.E.

Central Research Institute of Tuberculosis

ORCID: 0000-0002-2494-9275

Saenko S.S.

Regional Clinical Center of Phthisiopulmonology

ORCID: 0000-0002-3828-4091

Shcherbakova G.V.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-2541-8692

Kulaeva M.A.

Sechenov First Moscow State Medical University

ORCID: 0009-0009-4182-3592

Martel I.I.

Sechenov First Moscow State Medical University;
Medicine JSC;
Moscow Regional Clinical Tuberculosis Dispensary

ORCID: 0000-0001-7514-7320

Received:

21.04.2024

Accepted:

05.07.2024

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