Surgical reperation techniques bronchopleural fistulas

Bronchopleural fistula is one of the most troublesome complications that are seen after the thoracic surgery operations. In the process of treatment, multidisciplinary surgery modality is necessary. The purposes of this study are to compare surgical closing methods with nonsurgical methods in the cases with BPF, and to examine the surgical closing methods in terms of complete recuperation, recurrence, fistula, and survival. In our clinic between 2000-2016, there have been 52 patients who had fistula reparation because of BPF developed after anatomical resection. These patients were examined in terms of risk factors such as age, gender, diabetes mellitus, KOAH, tuberculosis, and using immunosuppressive drug use. In addition, these patients were investigated in terms of bronchus closing methods such as manual closing, closing with stapler, and subcarinal dissection in first surgery and in terms of recurrence, fistula, complete recuperation, and survival in pursuit of fistula reparation. In order to compare surgical closing methods with nonsurgical methods, and surgical closing methods in itself, univariate binary logistic regression analysis was used as a statistical method. In this study surgical methods were examined in two groups as omentopexy and living muscle tissue flaps (intercostal muscle, anterior serratus muscle, latissimus dorsi muscle, pectoralis major muscle, diafragma). Omentopexy was detected 6,250 times more predominantly in terms of complete recuperation than application of living muscle tissue flap (p= 0.058). Surgical methods were 3,753 times more superior in terms of full recovery than nonsurgical techniques (p = 0,026). Right pneumonectomy applications were seen 6,222 times more risky in terms of recurrence fistula than the other anatomical resections. The obtained results were statistically significant (p = 0,030). Left pneumonectomy applications, in terms of recurrence fistula, were not statistically significant (p = 0,975). Omentum transposition applications were not statistically significant (p=0,220) in term of recurrence fistula. In conclusion, it is seen that the surgical closing techniques are more ascendent among BPF reparation methods. In addition, the results demonstrated that omentopexy is more ascendent among surgical closing methods. Key Words: BPF, Full Recovery, Recurrence fistula