Placement of a Customised Y-Shaped Silicone Stent via the Transthoracic Approach for Closing a Large Bronchial Stump Fistula.

Abstract

Bronchial stump fistula occurs at the site of a lobectomy or segmentectomy and is a specific type of bronchopleural fistula. In addition to complications such as empyema and pneumothorax, a large bronchial stump fistula can result in decreased lung ventilation due to significant air leakage, particularly during general anaesthesia with endotracheal intubation, making closure of the large bronchial stump fistula challenging. The present paper reports on a case of a patient with a large right bronchial stump fistula who had difficulty maintaining normal oxygenation when using conventional tracheal intubation for mechanical ventilation. We utilised left-lung single-lung ventilation during the procedure to ensure adequate oxygenation and inserted a customised Y-shaped silicone stent via the transthoracic approach into the right-side fistula to occlude the bronchial stump fistula. A satisfactory outcome was achieved in this case.