Abstract:

Objective: To summarize and evaluate the treatment methods and clinical value of individualized precision therapy for closure of bronchopleural fistula (BPF) after lung cancer resection. Methods: A total of fifty-seven postoperative BPF patients with non-small cell lung cancer admitted to Tongde Hospital of Zhejiang Province from July 2018 to May 2023 were selected as the research subjects. The research subjects underwent thorough preparation and multidisciplinary discussions, and personalized precision treatment was applied for closure based on the location and size of the BPF. For small fistulas, precise surgical injection of biological glue was used to close the fistula tract. For middle fistulas, surgical suture combined with endoscopic one-way valves was used for closure. For large fistulas, improved surgical repair combined with endoscopic cardiac occluders was used for closure. The clinical efficacy of individualized precision therapy was analyzed. Results: All 57 study subjects completed individualized precision treatment without any in-hospital deaths. After surgery, 4 cases (7.0%) were ineffective, and 3 cases (5.3%) showed partial remission; 50 cases (87.7%) showed clinical symptom relief; two cases (3.5%) were complicated with aspiration pneumonia, two cases (3.5%) were complicated with subcutaneous hemorrhage, and three cases (5.3%) were complicated with incision infection, all of which improved after treatment. Among the 17 patients with small fistulas, 16 were successfully closed after treatment, and 1 was ineffective. Among the 25 patients with middle fistulas, 23 were successfully closed after treatment, 1 was ineffective, and 1 partially relieved. Among the 15 patients with large fistulas, 11 were successfully closed after treatment, 2 were ineffective, and 2 partially relieved. Conclusion: The application of personalized precision treatment for closure of BPF after lung cancer resection has a high success rate and significant therapeutic effect.

Key words: Bronchopleural fistula, Lung neoplasms, Therapeutic uses, Surgical procedures, operative