Application of 3D printing imaging technology in the treatment of bronchopleural fistula with individual customized bronchial occluder

Abstract

Background

Bronchopleural fistula (BPF) is a common and severe complication in thoracic surgery, characterized by its complex nature and high mortality rate. Bronchial occluder is one of the effective methods for the interventional treatment of BPF under bronchoscopy.

Objective

This work was to evaluate the adoption and efficacy of individualized bronchial occluder designed with the assistance of 3D printing technology in the treatment of BPF.

Material and Methods

This single-center, retrospective study included 60 patients (35 males and 25 females, aged 40–78 years, without severe dysfunction of major organs or history of mental disorders) diagnosed with BPF between January 2020 and December 2023, who received different treatment and were divided into the Control Group (CG, receiving thoracotomy treatment), Therapy group-I (TG-I, receiving septal occluder treatment), and Therapy group-II (TG-II, receiving treatment with 3D-printed individualized bronchial occluder). Serum levels of high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were measured by enzyme-linked immunosorbent assay preoperatively and at 1, 4, and 12 weeks postoperatively. Daytime cough scores were assessed according to guidelines, pain scores were evaluated using a visual analog scale, clinical efficacy was determined based on consensus criteria, and complications were recorded. Quantitative variables were compared using one-way ANOVA with Bonferroni correction, while categorical variables were analyzed by chi-square or Fisher’s exact test.

Results

the overall clinical efficacy was higher in TG-I and TG-II versus CG, with TG-II showing a greatly higher efficacy after twelve weeks of treatment (P < 0.05). Relative to CG, both TG-I and TG-II demonstrated lower serum levels of hs-CRP and PCT, markedly reduced cough and pain symptom scores, and markedly lower complication rates (P < 0.05). Additionally, TG-II resulted in notably lower serum inflammatory markers, cough and pain symptom scores, and complication rates versus TG-I (P < 0.05).

Conclusion

The 3D-printed personalized occluder (TG-II) significantly reduced postoperative inflammatory responses and alleviated cough-associated pain, demonstrating superior short-term efficacy and safety compared to conventional treatment (CG) and commercially available occluders (TG-I). This approach offers distinct advantages for the personalized precision treatment of BPF. However, further clinical studies are required to validate its potential as an alternative to surgical repair.