FIRST EXPERIENCE OF CELL TECHNOLOGIES IN THORACIC SURGERY

Bronchoscopic bronchial fistulas closing tactics, despite the merits, is not sufficiently developed and is of limited use. One of the new ways of improving this area may consist of endobronchial bronchus occlusion of the fistula using cellular technology. The purpose of this study was to evaluate the effectiveness of endoscopic treatment of postoperative bronchial fistulas using cultured allogeneic fibroblasts. The study included 10 patients with bronchopleural fistula after pneumonectomy transferred for lung cancer and infectious and destructive process. The diameter of the defect bronchial stump averaged 5 mm. Endobronchial intervention consisted of submucosal injection of a suspension allofibroblastov human bronchial stump fistula zone. Introduction of cell suspension was carried out in an isotonic saline submucosal fistula bronchus area 2-5 points total volume of 1.5 ml. Concentration allofibroblastov - 3 x 10 6 cells / ml. State of bronchial stump and residual pleural cavity to monitor the implementation of bronchoscopy, chest X-ray, CT scan. It is shown that after endobronchial administration fibroblast suspension clearance fistula was not detected in 6 cases out of 10. obturation of the lumen of the bronchus occurs within 7-9 days after cell transplantation. In the remaining patients fistula persisted, requiring re-cellular infiltration. Follow-up bronchoscopy in two cases the fistula ended blindly and do not communicate with the pleural cavity, the diameter of the fistula opening in two patients decreased significantly, but not completely closed. Thus, bronhoendoskopic submucosal administration of a suspension allofibroblasts in projection bronchial fistula should be considered as a promising method of conservative treatment failure bronchial stump after radical operations on the lungs, allowing 60-80% of cases, to avoid re-open surgery.

allogeneic fibroblasts, cell technology, bronchial fistula, endoscopic treatment, healing