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J Thorac Cardiovasc Surg 2002;124:1235-1236
© 2002 The American Association for Thoracic Surgery

Brief Communications

Closure of postpneumonectomy bronchopleural fistula by means of single, perforator-based, latissimus dorsi muscle flap

Edmund C. K. Chan, FRCSa, Tak Wai Lee, FRCSb, Calvin S. H. Ng, MBBS(Hons)a, Innes Y. P. Wan, FRCSb, Alan D. L. Sihoe, MBBChb, Anthony P. C. Yim, MDb Hong Kong, People's Republic of China

From the Divisions of Plastic and Reconstructive Surgeryb and Cardiothoracic Surgery,a Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong.

Received for publication Feb 14, 2002. Accepted for publication June 6, 2002. Address for reprints: Edmund C. K. Chan, MD, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong (E-mail: edmundchan@iname.com).

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  		Dr Chan

 
Bronchopleural fistula (BPF) is one of the most serious complications after pulmonary resection, with an incidence of 1.2% after lobectomy and between 2% and 20% after pneumonectomy.Go 1 The reported mortality rate can be as high as 71% despite aggressive treatment.Go 1 The diversity of treatment modalities indicates that no single regimen satisfies all conditions, and treatment options have to be individualized.

We successfully treated an elderly man who had postpneumonectomy empyema and BPF by the use of a perforator-based distal latissimus dorsi (LD) muscle flap.

Clinical summary

A 72-year-old Chinese man had BPF and empyema 1 month after a left pneumonectomy. Examination with a fiberoptic bronchoscope revealed a 4-mm fistula at the left main bronchial stump. Tube thoracostomy and systemic antibiotics were commenced, followed by surgical exploration, debridement of the infected cavity, and repair of the fistula after achievement of general anesthesia 4 days after presentation.

The patient was placed in a full right lateral decubitus position, with wide exposure of the left side of the chest and . . . [Full Text of this Article]






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