Endobronchial Valves in Pediatric Population: Minimal Invasive and Successful Treatment of Persistent Bronchopleural Fistula

Maria Pilar del Peral Samaniego*, Rosa Fonseca Martin, Carlos Gutierrez San Roman, Enrique Cases Videma, Juan Lopez Andreu, Jose Enrique Barrios Fontoba, Juan Encarnacion Martinez, Javier Lluna Gonzalez and Juan Jose Vila Carbo

Department of Pediatric Surgery, La Fe University and Polytechnic Hospital, Valencia, Spain

^*Correspondance to: Maria Pilar del Peral Samaniego 

 PDF  Full Text DOI: 10.25107/2474-1647.3260

Abstract

Purpose: Bronchopleural Fistula (BP) is a severe diagnose in pediatric hospitals, with a rising incidence in the last years. No clear protocols for treatment of persistent BPF have been described. The purpose of this report is to share our experience in the treatment of a persistent BF in a preschooler with an Endobronchial Valve (EV). Methods: A 10 months old patient was diagnosed of BPF secondary to a complicated pneumonia. After several weeks, despite efforts to improve his clinical situation, the BPF persisted. The evaluations of a multidisciplinary team encourage the use of EV as a treatment to BPF after ineffectiveness of conservative measures. The minimal invasive technique was performed in the operating room under sedation. The success of the intervention was measured according to patient’s clinical and radiological improvement, and possibility of extubation and hospital discharge. Results: No complications were reported. A clinical and radiological improvement was seen in 48 h, allowing the patient’s extubation. Valve withdrawal was performed 7 weeks later. No further interventions were needed. Conclusion: EV in pediatric patients can be a successful and safe treatment for BPF, avoiding more invasive or risky procedures. We would suggest, in the bases of this experience, a trial of endobronchial occlusion before other surgical options for a persistent BPF in selected patients.

Keywords

Endobronchial valves; Bronchopleural fistula; Bronchoscopic treatment; Bronchial occlusion

Cite the article

del Peral Samaniego MP, Martin RF, San Roman CG, Videma EC, Andreu JL, Barrios Fontoba JE, et al. Endobronchial Valves in Pediatric Population: Minimal Invasive and Successful Treatment of Persistent Bronchopleural Fistula. Clin Surg. 2021; 6: 3260..