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J Thorac Cardiovasc Surg 2005;129:692-693
© 2005 The American Association for Thoracic Surgery

Brief Communications

Successful closure of an empyema space associated with persistent bronchopleural fistula: Muscle transposition combined with endobronchial plug

Hisashi Oishi, MD*, Akira Miyamoto, MD, Akira Sakuraada, MD, Yasushi Hoshikawa, MD, Hirokazu Aikawa, MD, Satoshi Suzuki, MD, Masami Sato, MD, Takashi Kondo, MD

Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan

Received for publication June 21, 2004; revisions received July 22, 2004; accepted for publication July 28, 2004.

* Address for reprints: Hisashi Oishi, Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku Sendai 980-8575, Japan (E-mail: bigstone@idac.tohoku.ac.jp).

The first 20% of the full text of this article appears below.

Empyema associated with bronchopleural fistula (BPF) is one of the serious complications after pulmonary resection.1 Various methods (eg, direct suture of BPF, omental and muscular transposition, thoracoplasty, or a combination of them) have been indicated to treat empyema. However, these treatments often fail because of the recurrent BPFs.1-4 In these treatments, complete obliteration of residual pleural space is important to prevent the recurrence of BPF.

Here we report a successful treatment for a patient with persistent BPF. The patient was lean and did not have enough muscles for pleural space obliteration, so we devised a new method—muscle transposition combined with an endobronchial plug.


   Clinical summary
 
A 70-year-old man was admitted to our hospital because of empyema associated with BPF. Eleven months before admission, the patient underwent right upper lobectomy and right S6 partial resection for a lung nodule at another hospital. The pathologic diagnosis was pulmonary amyloidosis. Two months later, intrathoracic muscular transposition (latissimus dorsi muscle) and omentopexy were performed for BPF after the pulmonary resection. . . . [Full Text of this Article]






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