Emergency General Hospital's thoracic surgery combined with multiple disciplines successfully cured a bronchial pleural fistula patient

Author:Emergency Hospital Time:2022.08.12

Say goodbye to the road to block and start a new life

Bronchial pleural fistula has always been a major problem facing thoracic physicians. Although surgery technology, surgical equipment, and perioperative management are continuously improving and improving, the treatment is still very tricky.

Recently, the thoracic surgery team of the Emergency General Hospital is closely collaborated with the departments such as the Department of Burning Plastic Surgery and the Department of Internal Medicine, and successfully cured a bronchial pleural fistula patient.

Express the grace of life -saving

Turquism dates back to June 2021. Luo, a 70 -year -old patient, went to the hospital for cough and sputum. He found that the right lung had a lesion and was accompanied by the thoracic effusion. Leaf cutting+fiber plate removal+pusbaldia clearance. Luo Mou thought he could live a healthy and happy life after surgery. Unfortunately, he always cough, sputum, and asthma after surgery. He went to the hospital on August 12, 2021. A drainage tube is placed in the inside of the chest cavity, which leads to the omission gas daily. From then on, Luo Mou had to hold the drainage bottle in his right hand wherever he went, which seriously affected his physical and mental health, and greatly increased the burden on the family. In order to live a normal life, he began a long way to block the fistula and tried various fistula -blocking methods.

On December 2, 2021, and January 13, 2022, Luo moved to two different hospitals to block the mouth of the building twice. The effect was not good, and both ended in failure. On the occasion of the way, on April 19, 2022, Luo Mou introduced the thoracic surgery of Beijing Emergency Hospital, hoping to get rid of the trouble of the drainage tube and restore normal life.

Traditional surgical fistulating methods are to remove more and ribs to completely collapse the chest wall to achieve the purpose of closed fistula. This type of method has huge surgery and trauma, and it has seriously affected the patient's breathing function and aesthetics due to the destruction of the chest wall. Most patients refuse. Wang Dawei, deputy chief physician of the General Surgery Department of Emergency Hospital, has long been engaged in the research and treatment of bronchial pleural fistula, especially under the protection of chest wall shape protection. The effective treatment of bronchial pleural fistula has rich experience. Carefully analyzes the patient's medical history, image data and treatment process: Luo's bronchial pleural fistula is> 0.5cm, which belongs to a central large fistula, and the fistula lasted for nearly 1 year. Deputy Chief Physician Wang Dawei discussed with multi -disciplinary experts such as the Department of Internal Medicine, Burning and Plastic Surgery, and on the basis of completely cure fistula, try to protect the complete state of the thorax and formulate an individualized treatment plan for Luo: take out two. After about 2cm long ribs, muscle petal metastasis filling+VSD wound negative pressure drainage surgery is performed. Due to the precise prediction, rich experience, fine operation, and tacit understanding, the surgery was successful, the patient's bronchial pleural fistula was completely cured, the thoracic drainage tube was successfully removed, and the thoracic contour maintained a normal form.

When he was discharged from the hospital, Luo stood in front of the medical staff who had treated him with excitement: "Your technology is too high, I can finally go home, thank you for giving me hope and self -confidence in life. I will remember this kind of kindness. ! ""

Expert reminder

The bronchial pleural fistula refers to a fistula formed between the bronchial trachea and the pleural, which is one of the severe complications of lung surgery. Its incidence is 1%to 5%, and the mortality rate is 16%to 71%. Trust. The treatment of bronchial pleural fistula mainly includes: conservative support treatment, endoscopic intervention therapy and surgical treatment, and individualized treatment plans need to be developed according to the specific conditions of the patient. Conservative treatment mainly includes pleural tubular drainage, antibiotics, and nutritional support; the main methods of interventional therapy include two types: blocking agent and blocking device. Coils and bronchial endometrium silicon or metal stents, etc.; The main methods of surgical treatment include directly closed from the residual end, soft tissue petals (such as pericardial and pectoral muscles, etc.) with vascular ethics covering bronchial residues, lung resection, surgical thoracoscopy treatment, and (or) Polaris changes, etc. For early bronchial residual fistula, surgery to repair the triminal residual end is the best treatment, and it is suitable for patients with better physical condition. Surgical treatment is mainly applicable to fistulas greater than 5mm or invalid interventional treatment.

Profile

Emergency General Hospital's thoracic surgery is one of the key departments of the hospital. The hospital hires a famous thoracic surgery expert "China's first person" Professor Chen Jingyu as the leader of the discipline. Essence The department's talent has strong talents, complete hardware equipment, mature technology, and reasonable talent echelon. It is always based on the service concept of "people -oriented, serving first", implemented individualized and standardized treatment, and is proficient in minimally invasive surgery of chest diseases, such as whole thoracoscopy Lung cancer root treatment, single -hole thoracoscopic pulmonary lobe and sub -lobe slicing, whole thoracosausal laparoscopic esophageal cancer root treatment, whole thoracoscopic longitizure tumor sketching, etc.; Surgery, especially for local advanced non -small cell lung cancer, has unique insights in comprehensive therapy for surgery; has accumulated rich clinical experience in the fields of complex, severe chest trauma, thymoma and severe muscle weakness. At the same time, actively carry out the overall medical service model of the integrated medical care, and provide patients with high -quality rapid rehabilitation services for patients perimage treatment.

Expert Introduction

Chen Jingyu, director of chest surgery, chief physician, professor, deputy director of the National Emergency Medical Research Center, Dean of Wuxi Organ Transplantation Research Institute, director of the Jiangsu Provincial Lung Transplantation Center, and Deputy Dean of the Second Hospital of Zhejiang University. Professor Chen Jingyu is a representative of the National People's Congress and a winner of the National May Day Labor Medal. After 30 years of clinical work in thoracic surgery, it is good at local advanced lung cancer root treatment, lung transplantation, thoracoscopy surgery, lung cancer expansion, comprehensive treatment of lung cancer, and ECMO applications, especially in local advanced lung cancer surgery and lung transplantation. Hundreds of local advanced lung cancer treatment and lung transplantation can be completed each year, and most of them are complex and difficult surgery. In recent years, it has promoted the green channel of Chinese organs and promoting brain death legislation. Yang Longhai, deputy director and deputy chief physician of the General Hospital of Emergency Hospital, has been engaged in diagnosis and surgical treatment of common diseases in the chest for a long time. He is good at minimally invasive surgery of thoracoscopy. Such as the surgical treatment of lung cancer, esophageal cancer, and hypertrophy tumors, especially in local advanced lung cancer surgery treatment; with solid surgical skills, participating in more than 4,000 cases of thoracic surgery, more than 1,500 examples of thoracic surgery, clinical experience in clinical experience, clinical experience Rich.

Wang Dawei, deputy chief physician of chest surgery at the Emergency General Hospital, graduated from the Cancer Hospital of the Chinese Academy of Medical Sciences of Beijing Union Medical College. He has been engaged in clinical first -line work for a long time. Surgery, especially the rapid treatment of severe thoracic trauma and bronchial pleural fistulating treatment, has rich experience in the treatment of bronchial pleural fistula. The treatment of thoracic trauma first aid, thoracoscopy rib fracture and surgical treatment of bronchial pleural fistula has reached the domestic advanced level.