Review Note
Last Update: 02/27/2025 04:42 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
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Field Change Suggestions:
Front
Commit #291099
SS_TS 1.21 Outline the management of the following postoperative complications associated with thoracic surgery:
- Bronchopleural fistula
- Bronchopleural fistula
Back
Commit #291099- Bronchopleural fistula:
- Incidence post-pneumonectomy 4-20%
- More likely with right pneumonectomy as right bronchus is supplied by single bronchial artery (left supplied by 2)
- Right bronchial stump is exposed at the end of operation, surgeons cover it with a well vascularised tissue flap (intercostal muscle), left usually retracts behind aorto-pulmonary window
- Other risks:
- Prolonged post-op ventilation
- Residual tumour in stump
- Large diameter stumps
- Early presentation::
- Cough
- Air leak from chest drain
- Falling fluid level (on CXR)
- New air-fluid level on CXR
- Later presentations (>2 weeks):
- Nonspecific signs and empyema]
- Treatment:
- Draining pleural space if associated with empyema
- Antibiotics
- Surgical repair - condition should be optimised and stabilised but rarely need to proceed prior to stabilisation, difficult anaesthetic as cardiovascular collapse and need rapid lung isolation to avoid overspill from BPF into good lung