Xenopericard combined with NPWT (negative pressure wound therapy) in the treatment of advanced pleural empyema with bronchopleural fistula (clinical follow-up)

The development of bronchopleural fistula (BPS) against the background of advanced pleural empyema, as a result of severe pneumonia, is a formidable complication. The most significant obstacle in the surgical treatment of this group of patients is: a pronounced comorbid background, low functional indicators of patients, high requirements for surgical technique when performing reconstructive plastic interventions in BPS. Multiple surgical methods for treating bronchopleural fistulas are suggested. The first of these were to suture the defect. However, access through the infected pleural cavity leads to suture eruption and recurrence of the fistula, despite the fact that some authors have proposed combining these operations with various variants of myoplasty, thoracoplasty, removal of the fibrous capsule of empyema. Unsatisfactory functional and cosmetic outcomes during these surgical interventions led to the development of endoscopic, minimally invasive surgical interventions. Modern technologies allow temporary endoscopic bronchiococclusion, which stops the release of air from the defect. However, at the same time, she "turns off " part of the lung tissue from the gas exchange. Prolonged bronchial occlusion leads to the development of pneumonia with an outcome in the destruction of lung tissue. Our team of authors treatment of bronchopleural fistula with xenopericardium in combination with negative pressure therapy. This area seems to us very promising, and in this work we would like to share our first experience.