Interventional continuous negative pressure drainage for bronchopleural fistula: case series and literature review

Background: Bronchopleural fistula (BPF) is a serious complication of pulmonary resection. The purpose of this study was to evaluate the safety and efficacy of interventional continuous negative pressure drainage (CNPD) in the treatment of post-lobectomy bronchopleural fistula complicated by hydropneumothorax.Methods: A retrospective analysis of patients with BPF complicated by hydropneumothorax who underwent interventional CNPD was performed, in addition to a review of the literature. This study was registered in China clinical trial registry (Registration No.: chictr-ooc-15006036).Results: Among the 5 patients included, the one-time success rate of drainage catheter placement was 100%. No complications such as hemoptysis, hemothorax and asphyxia were reported. The patients' pneumonia severity index score significantly decreased from 99.8 ± 8.90 pre-intervention to 69.8 ± 14.03 three to seven days post-intervention (P < 0.001), with significant improvement and resolution of chest tightness, dyspnea and fever. The average indwelling time was 149.8 ± 56.059 days (95% CI: 39.72 –259.48).Conclusion: Interventional CNPD is minimally invasive, accurate and effective, allowing for rapid lung re-expansion, residual cavity elimination, and symptomatic relief. It thereby carries the potential as a novel treatment for BPF.