What is a bronchoplasty?

Bronchoplasty
Bronchoplasty is used for various benign and malignant pulmonary lesions.

Bronchoplasty is a reconstruction or repair of the bronchus to restore its function.

During inhalation, air travels through the nose and/or mouth into the trachea (windpipe). The trachea further divides into two tubes called bronchus (bronchi). The bronchi branch out into smaller tubes called bronchioles. The end of bronchioles opens into little air sacs called alveoli. The alveoli are surrounded by blood vessels, and its function is to exchange oxygen and carbon dioxide from the bloodstream.
 

When is a bronchoplasty reconstruction procedure used?

Bronchoplasty is used for various benign and malignant pulmonary lesions. Stenosis of the bronchus (narrowing of the bronchus) due to inflammation, infection or trauma may also require bronchoplasty.

When can a bronchoplasty not be performed?

Contraindications for bronchoplasty include:

  • A psychologically unstable patient
  • Poor cardiac (heart) status
  • Coagulopathy (bleeding disorder)
  • Consumption of high-dose steroids
  • Severe underlying medical conditions

Factors that increase postoperative risk for any thoracic surgery, including bronchoplasty are:

How is a bronchoplasty performed?

Before the procedure

  • The surgeon performs a complete physical assessment, along with radiological tests (X-ray, CT scan, angiography) and laboratory tests. The patient is advised to quit smoking before surgery, as smoking delays the healing process. The patient is required to fast for at least 12 hours before surgery. Consent is obtained prior to surgery.
  • A bronchoplasty is typically performed under general anesthesia.

The procedure

Various surgical techniques are available. The choice of surgical technique depends on the condition being treated, the extent of the disease and the surgeon’s discretion.

The surgical techniques are:

  • Open bronchoplasty
    • It is performed via an open thoracotomy or thoracoscopic video-assisted thoracic surgery (VATS). VATS is less invasive. Small incisions are made on the skin above the chest cavity to insert a thoracoscope (camera with a light source) and surgical instruments. VATS also allows for a quicker recovery and is associated with lesser postoperative pain than an open thoracotomy.
  • Balloon bronchoplasty
    • Bronchoscopic balloon dilation is a simple, nontraumatic, minimally invasive, safe, and rapid method to dilate a stenosis and restore adequate airflow.
  • Thermal Bronchoplasty
    • Thermal bronchoplasty is performed using a flexible bronchoscope. Three separate outpatient procedures are performed three weeks apart. Radiofrequency energy is delivered to a wire basket attached to the top of the catheter. The heat warms the lining of targeted airways to reduce airway smooth muscle mass. It helps reduce, debulk or partially eliminate smooth muscle tissue and widen the airway.

After the procedure

  • Patients are administered painkillers and antibiotics.
  • Patients are required to stay in the hospital for three to seven days in case of open surgery.
  • Patients can go home the same day after balloon bronchoplasty and thermal bronchoplasty.
  • Pain, bruising and swelling may be present in the postoperative period for open surgery, which usually resolves in one to two weeks.
  • Complete recovery would take a few weeks for open surgery.

QUESTION

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What are the complications of bronchoplasty?

Complications vary depending on the surgical technique performed.

Open bronchoplasty

Thermal bronchoplasty

Balloon bronchoplasty

  • Chest pain
  • Bronchospasm
  • Airway rupture
  • Pneumothorax (presence of air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung)
  • Hemothorax (collection of blood in the space between the chest wall and the lung)
  • Infection

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Medically Reviewed on 7/6/2020
References
Medscape Medical Reference

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