Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula
The OBJECTIVE was to retrospectively study the results of treatment of mediastinal bronchogenic cysts (MBC), to present a case of the formation of a cystobronchial fistula after a transbronchial cyst puncture.METHODS AND MATERIALS. MBC were diagnosed in 11 (20 %) of 55 patients with various mediasti...
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Pavlov First Saint Petersburg State Medical University
2024-10-01
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| Series: | Вестник хирургии имени И.И. Грекова |
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| Online Access: | https://www.vestnik-grekova.ru/jour/article/view/2433 |
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| author | S. A. Plaksin A. A. Gorodilov |
| author_facet | S. A. Plaksin A. A. Gorodilov |
| author_sort | S. A. Plaksin |
| collection | DOAJ |
| description | The OBJECTIVE was to retrospectively study the results of treatment of mediastinal bronchogenic cysts (MBC), to present a case of the formation of a cystobronchial fistula after a transbronchial cyst puncture.METHODS AND MATERIALS. MBC were diagnosed in 11 (20 %) of 55 patients with various mediastinal cysts. The diagnosis was confirmed by computed tomography data, in one case by a transbronchial puncture. All patients were operated on.RESULTS. MBC was asymptomatic in 8 cases (72.7 %). Neoplasm in the mediastinum was detected during fluorographic examination in 5 patients, with CT in 6 cases. The dimensions of the cysts according to CT data were 45.5±15.2mm and 39.3±17.5mm, respectively. MRI was performed in two patients due to comorbid pathology of the spine. A 60-year-old patient underwent a transbronchial biopsy with biopsy forceps for diagnostic aim, as a result of which the cyst cavity was opened, infected, and a cystobronchial fistula with a diameter of 2 mm was formed with constant coughing up the purulent contents of the cyst. After anti-inflammatory, antibacterial therapy, after a month and a half, the cyst was removed by thoracotomy due to a pronounced periproccess. Video-assisted thoracoscopic cystectomy was performed for 9 patients. One patient was underwent conversion to thoracotomy due to the adhesive process after a previously performed lobectomy. Exudative pleurisy developed from postoperative complications in one case.CONCLUSION. The main method of diagnosing MBC is computed tomography. The ultrasound-guided transbronchial needle puncture of a cyst can be used to clarify the diagnosis under antibiotic prophylaxis, but can lead to infection of the cyst. Thoracoscopic excision of MBC should be considered the first-line therapeutic option due to the risk of complications and the presence of clinical manifestations. |
| format | Article |
| id | doaj-art-08bbb1523c4c470191f0bcaedb41a0fc |
| institution | Kabale University |
| issn | 0042-4625 |
| language | Russian |
| publishDate | 2024-10-01 |
| publisher | Pavlov First Saint Petersburg State Medical University |
| record_format | Article |
| series | Вестник хирургии имени И.И. Грекова |
| spelling | doaj-art-08bbb1523c4c470191f0bcaedb41a0fc2025-08-20T04:00:33ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252024-10-011832303510.24884/0042-4625-2024-183-2-30-351603Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistulaS. A. Plaksin0A. A. Gorodilov1E. A. Vagner Perm State Medical UniversityE. A. Vagner Perm State Medical UniversityThe OBJECTIVE was to retrospectively study the results of treatment of mediastinal bronchogenic cysts (MBC), to present a case of the formation of a cystobronchial fistula after a transbronchial cyst puncture.METHODS AND MATERIALS. MBC were diagnosed in 11 (20 %) of 55 patients with various mediastinal cysts. The diagnosis was confirmed by computed tomography data, in one case by a transbronchial puncture. All patients were operated on.RESULTS. MBC was asymptomatic in 8 cases (72.7 %). Neoplasm in the mediastinum was detected during fluorographic examination in 5 patients, with CT in 6 cases. The dimensions of the cysts according to CT data were 45.5±15.2mm and 39.3±17.5mm, respectively. MRI was performed in two patients due to comorbid pathology of the spine. A 60-year-old patient underwent a transbronchial biopsy with biopsy forceps for diagnostic aim, as a result of which the cyst cavity was opened, infected, and a cystobronchial fistula with a diameter of 2 mm was formed with constant coughing up the purulent contents of the cyst. After anti-inflammatory, antibacterial therapy, after a month and a half, the cyst was removed by thoracotomy due to a pronounced periproccess. Video-assisted thoracoscopic cystectomy was performed for 9 patients. One patient was underwent conversion to thoracotomy due to the adhesive process after a previously performed lobectomy. Exudative pleurisy developed from postoperative complications in one case.CONCLUSION. The main method of diagnosing MBC is computed tomography. The ultrasound-guided transbronchial needle puncture of a cyst can be used to clarify the diagnosis under antibiotic prophylaxis, but can lead to infection of the cyst. Thoracoscopic excision of MBC should be considered the first-line therapeutic option due to the risk of complications and the presence of clinical manifestations.https://www.vestnik-grekova.ru/jour/article/view/2433bronchogenic mediastinal cystscomputed tomographybronchoscopycysto-bronchial fistulathoracoscopythoracotomy |
| spellingShingle | S. A. Plaksin A. A. Gorodilov Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula Вестник хирургии имени И.И. Грекова bronchogenic mediastinal cysts computed tomography bronchoscopy cysto-bronchial fistula thoracoscopy thoracotomy |
| title | Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula |
| title_full | Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula |
| title_fullStr | Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula |
| title_full_unstemmed | Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula |
| title_short | Surgical tactics of mediastinal bronchogenic cysts. A rare complication – cystobronchial fistula |
| title_sort | surgical tactics of mediastinal bronchogenic cysts a rare complication cystobronchial fistula |
| topic | bronchogenic mediastinal cysts computed tomography bronchoscopy cysto-bronchial fistula thoracoscopy thoracotomy |
| url | https://www.vestnik-grekova.ru/jour/article/view/2433 |
| work_keys_str_mv | AT saplaksin surgicaltacticsofmediastinalbronchogeniccystsararecomplicationcystobronchialfistula AT aagorodilov surgicaltacticsofmediastinalbronchogeniccystsararecomplicationcystobronchialfistula |