Bronchopleural fistula following lung cancer surgery: a case report

Bronchopleural fistula is a severe complication following lung cancer resection, often associated with compromised blood supply and impaired healing. It particularly affects elderly patients with underlying conditions, and its management heavily relies on minimally invasive techniques. This report describes a case of BPF developing after right middle and lower lobe resection in a 70-year-old male patient with squamous cell carcinoma and comorbidities including a 40-pack-year smoking history, 30-year history of hypertension, coronary heart disease, and 17-year history of diabetes mellitus. Initial endoscopic autologous blood plugging combined with stent placement failed. A second treatment innovatively employed a SIS (porcine small intestinal submucosa) absorbable reinforcement patch to plug the fistula opening, supplemented with fibrin adhesive and autologous blood. Postoperative CT confirmed fistula closure and reduced chest wall air accumulation. This approach integrates the mechanical support and degradable properties of SIS absorbable reinforcement patches, the sealing effect of fibrin glue, and the activation of endogenous coagulation mechanisms by autologous blood, forming a synergistic system of “physical barrier-biological adhesion-self-repair.” It offers a potential alternative approach for high-risk bronchopleural fistulas resistant to endoscopic closure.