{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:47:28Z","timestamp":1791989248729,"version":"4.4.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microwave ablation (MWA) is an established local therapy for selected pulmonary nodules in patients who are poor candidates for surgery. Bronchopleural fistula (BPF) is a rare but serious complication after lung ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 74-year-old woman with prior bilateral thoracic interventions and impaired pulmonary reserve underwent CT-guided percutaneous MWA (30\u00a0W for 4\u00a0min) for a right upper lobe ground-glass nodule on post-ablation day (PAD) 0. On PAD2, chest radiography showed a large right pneumothorax with more than 50% right lung compression, and right chest tube drainage was promptly performed with symptomatic improvement. On PAD5, she developed worsening chest tightness and rapidly increasing fever; in the context of recurrent pneumothorax and poor lung re-expansion despite chest drainage, urgent CT showed findings highly suggestive of BPF with pleural infection\/empyema, including an air-fluid cavity along the ablation tract. Emergency VATS was performed on the same day. Intraoperatively, a thick-walled purulent necrotic cavity was identified along the ablation tract and communicated with a distal branch of the anterior segmental bronchus. Thoracoscopic adhesiolysis, decortication, debridement, partial pulmonary resection of the fistula-bearing lung tissue, pleural irrigation, and chest tube drainage were performed. The pneumothorax resolved, lung re-expansion was satisfactory, and the patient recovered and was discharged. At 3 months, no clinical evidence of recurrent fistula or need for reintervention was observed, and 1-month CT showed no definite radiologic evidence of recurrent BPF, empyema, or local progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights that BPF may occur early even after low-power lung MWA. In a post-MWA pneumothorax patient, new fever, poor lung re-expansion despite chest drainage, and a CT air-fluid cavity along the ablation tract should raise suspicion for MWA-tract-related BPF. In selected severe cases with pleural infection\/empyema and a non-expanding lung, prompt thoracoscopic source control may be considered, but a single case cannot define a universal management algorithm.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04526-7","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:04:56Z","timestamp":1784531096000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency thoracoscopic management of early ablation-tract bronchopleural fistula after low-power lung microwave ablation: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Weike","family":"Lv","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiewen","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongjie","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"issue":"10\u2013S","key":"4526_CR1","doi-asserted-by":"publisher","first-page":"e2020002","DOI":"10.23750\/abm.v91i10-S.10342","volume":"91","author":"P Mendogni","year":"2020","unstructured":"Mendogni P, Daffr\u00e8 E, Rosso L, Palleschi A, Righi I, Carrinola R, et al. 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Br J Radiol. 2015;88:20140598. https:\/\/doi.org\/10.1259\/bjr.20140598.","journal-title":"Br J Radiol"},{"key":"4526_CR8","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.ccm.2025.02.015","volume":"46","author":"JD Duke","year":"2025","unstructured":"Duke JD, Lentz RJ. Treatment of Bronchopleural Fistula. Clin Chest Med. 2025;46:383\u201391. https:\/\/doi.org\/10.1016\/j.ccm.2025.02.015.","journal-title":"Clin Chest Med"},{"key":"4526_CR9","doi-asserted-by":"publisher","first-page":"e129","DOI":"10.1016\/j.jtcvs.2017.01.030","volume":"153","author":"KR Shen","year":"2017","unstructured":"Shen KR, Bribriesco A, Crabtree T, Denlinger C, Eby J, Eiken P, et al. The American Association for Thoracic Surgery consensus guidelines for the management of empyema. 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