Anastomotic Airway Complications after Lung Transplantation

作者：Cho Eun Na; Haam Suk Jin; Kim Song Yee; Chang Yoon Soo; Paik Hyo Chae^*

来源：Yonsei Medical Journal, 2015, 56(5): 1372-1378.

DOI：10.3349/ymj.2015.56.5.1372

• Lung transplantation
• postoperative complications
• surgical anastomosis

Purpose: Anastomotic airway complications are a major cause of morbidity and mortality after lung transplantation (LTx). In this study, the authors identified types and clinical outcomes of airway complications after LTx.
Materials and Methods: All bronchial anastomotic complications were analyzed in a total of 94 LTx cases involving 90 recipients who underwent surgery between July 2006 and May 2014. Fifteen La cases (14 recipients) with incomplete medical records for fiberoptic bronchoscopy (FBS) and three cases underwent heart-lung transplantation (HLT) were excluded. Postoperative FBS at 24-48 hours, 1, 3, 6, and 12 months, and then yearly after the transplantation were performed.
Results: A total of 76 LTx cases (75 recipients) were analyzed. The mean age of the recipients was 49.55 years (range, 18-71 years), and 38 (49.4%) were male. Twenty-one out of 76 cases (27.6%) experienced early anastomotic complications, and 12(15.8%) presented late anastomotic complications. The early anastomotic airway complications presented in various forms: stenosis, 1 case; narrowing, 1; necrosis & dehiscence, 3; fistula, 4; granulation, 10; and infection, 2. Late complications almost entirely presented in the form of bronchial stenosis; five recipients showed stenosis at the anastomosis site, and one of them showed improvement after ballooning. Five others were found to have stenosis at the bronchus intermedius, distal to the anastomosis site. Three of these patients showed improvement after ballooning or bronchoplasty.
Conclusion: By serial surveillance via FBS after La, we detected anastomotic airway complications in 42.9% of cases, which were successfully managed with improved clinical outcomes.

• 出版日期2015-9-1