支气管胸膜瘘诊疗:从传统手术到生物精准修复的范式转变与未来展望OACHSSCD

Bronchopleural fistula(BPF)is defined as an abnormal pathological communication between the bronchial tree and the pleural cavity,allowing the passage of air,secretions,or infectious materials.It represents a severe complication following thoracic surgery and can also result from infection,trauma,tumors,or iatrogenic injuries.Although the incidence of BPF remains low,its high mortality,challenging management,and prolonged clinical course have long made it a persistent clinical dilemma in the fields of thoracic surgery and interventional pulmonology.In recent years,with the rapid advancement of respiratory endoscopy,biomaterials,regenerative medicine,and precision surgery,the diagnostic and therapeutic paradigm for BPF has shifted from traditional open surgery toward minimally invasive interventions,biological repair,and individualized precision treatment.This article systematically reviews the etiology,pathogenesis,clinical manifestations,diagnostic approaches,conventional treatments,and prognosis of BPF.Based on the latest domestic and international research developments,the clinical application of innovative modalities including endoscopic closure,novel biomaterials,tissue-engineered repair,robotic-assisted surgery,and minimally invasive techniques is highlighted.Furthermore,existing challenges and future directions are discussed,aiming to provide a theoretical foundation for optimizing clinical management and guiding related research endeavors.