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Ichilov Medical Center
Pulmonology

Treatment of Bronchial Fistula in Israel — Progressive Methods and High Results

Foreign patients often turn to Israeli clinics for bronchial fistula therapy. Many of them have undergone multiple surgical operations in their home countries but have not achieved positive results. Treatment of bronchial fistula in Israel is developed and carried out by highly qualified doctors, following an individual program that includes effective progressive methods. Minimally invasive endoscopic interventions and closure of the fistula using septal occluders are professionally performed in medical centers in Israel.

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bronchial fistulaFor the proper establishment of treatment tactics, consultations with specialists and comprehensive examination of the patient are required. Equipped with state-of-the-art high-precision equipment, diagnostic centers in Israeli clinics rank first in the world. Various types of diagnostic procedures provide doctors with detailed information, based on which a diagnosis is established and therapy is prescribed. Reviews left in clinics and on websites emphasize the comfortable conditions for undergoing treatment, the cost of which is lower than in other popular countries and accessible to most.

Treatment Methods for the Disease

A bronchial fistula is a fistula that causes an anatomically incorrect connection between the bronchus and any internal organ, cavity, or skin surface. This pathology is one of the most relevant in clinical pulmonology and thoracic surgery, due to its resistance to conservative therapy and stimulation of chronic purulent inflammation. Additionally, the presence of a bronchial fistula significantly worsens the prognosis after surgical intervention.

Bronchial fistulas can be congenital or acquired. Congenital ones arise from intrauterine developmental disorders. For example, tracheoesophageal and bronchoesophageal fistulas form due to incomplete separation of the digestive and respiratory systems of the fetus. The following causes of acquired bronchial fistulas are identified:

  • postoperative complications;
  • infectious-inflammatory diseases of the respiratory organs (tuberculosis, bacterial destruction, and lung abscess);
  • injuries.

Bronchial fistulas can be external (thoracobronchial) and internal (bronchopleural, broncho-pulmonary, broncho-organ).

Clinical signs are determined by the location of the fistula, its characteristic features, stage of development, and the presence of infectious-inflammatory processes. General symptoms include loss of appetite, elevated temperature, headache, fatigue, and weakness.

In external fistulas, a visible defect forms on the skin of the chest, from which a mucous exudate with admixtures of pus is released. Bronchopleural fistulas manifest as a dry cough, and those arising as a complication of purulent pleuritis show signs of intoxication (high temperature, headache, loss of appetite) and respiratory failure (shortness of breath, cyanosis, chest pain). This type of pathology is also characterized by the release of a large amount of foul-smelling sputum. For broncho-organ fistulas, it is typical for the patient to cough up the contents of the organ connected to the bronchus.

The therapeutic scheme includes effective conservative and surgical methods suitable for the patient.

Thoracentesis

Drainage of the pleural cavity is among the conservative treatment methods aimed at sanitizing the cavity using a special drainage tube. The procedure is performed under local anesthesia, under the control of ultrasound and CT. If indicated, the pleural cavity is washed with a solution of antibiotics or antiseptic agents.

Electrocoagulation

This procedure is based on the effect of high-frequency electric current, which leads to a sharp increase in local temperature and destruction of pathological tissues. This destroys the epithelial layer of the bronchus, stimulating the growth of connective tissue in the channel.

Surgical Treatment

Unfortunately, a positive effect from conservative methods is observed in just over 10% of cases. The most effective way to eliminate the pathology is surgical intervention aimed at closing the fistula. Depending on the type of pathology, different surgical techniques are indicated.

  • Reamputation of the bronchial stump — indicated for the development of postoperative bronchial fistulas, the essence of the operation is re-resection and subsequent suturing of the bronchial stump.
  • Endobronchial closure of the fistula — the operation is performed with the installation of special septal occluders, which form a kind of patch. As a result, the fistula gradually closes. The intervention is performed endoscopically, requiring no large incisions, characterized by low trauma and risk of complications, and a short recovery period. The procedure is conducted under radiological control, and the surgeon monitors the course of the operation through images transmitted to a monitor from the bronchoscope camera.

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Diagnostic Methods for the Disease

In diagnostic centers in Israel, consultations and examinations of the patient are organized efficiently, requiring no waiting or queuing, and take about three days.



Upon arriving at the clinic, the patient is directed to a primary consultation with the treating pulmonologist, during which the doctor reviews the provided medical documentation (results of studies conducted in the home country, conclusions from specialists, discharge summaries from hospitals), clarifies the nature and severity of symptoms with the patient, and collects the medical history. After a superficial and physical examination, necessary diagnostic procedures are prescribed.


The examinations include:

- X-ray examination of the lungs;

- CT of the lungs;

- bronchography;

- bronchoscopy;

- diagnostic thoracoscopy;

- fistulography (conducted to determine the length and structure of the fistulous channel);

- pleural puncture;

- esophagogastroscopy.



The results of the studies are reviewed by a council consisting of a pulmonologist and narrow-profile specialists. Based on the studied indicators, the doctors establish the final diagnosis and prescribe treatment.

  • Computed Tomography
  • A new minimally invasive diagnostic method in Israel — thoracoscopy
  • X-ray of the chest

How Much Does Treatment Cost

The cost of the therapeutic course is extremely important for patients. Treatment in Israeli clinics costs approximately 30-50% less than in medical centers in Western Europe and the USA.

Advantages of Treatment in Israel

  • High level of qualification and extensive experience of doctors.
  • High-tech medical diagnostic equipment.
  • Use of progressive therapy methods.
  • Rapid accurate diagnostics.
  • Affordable prices.

The success of therapy primarily depends on the timeliness of its initiation. To recover and restore, contact your chosen clinic without delay and entrust your health to the leading specialists in the world.

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