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Jerome Mouroux
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J Thorac Cardiovasc Surg 2006;132:1490-1491
© 2006 The American Association for Thoracic Surgery

Brief Communication

Closure of left-sided bronchopleural fistula by video-assisted mediastinoscopy: Is it always possible?

Nicolas Venissac, MD*, Daniel Pop, MD, Jerome Mouroux, MD

Thoracic Surgery Department, Pasteur Hospital, Nice, France.

Received for publication July 10, 2006; accepted for publication August 8, 2006.

* Address for reprints: Nicolas Venissac, MD, Thoracic Surgery Department, Pasteur Hospital—Building H1, 30 Avenue de la Voie Romaine, 06002 Nice, France. (Email: venissac.n@chu-nice.fr).

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

Postpneumonectomy bronchopleural fistula (BPF) is a major challenge for thoracic surgeons. Despite widespread understanding of the risk factors, the incidence varies from 0.5% to 4.5% and the mortality is still as high as 71.2%.1Go Succesful treatment requires an individual approach in each patient. We report our experience with closure of a left-sided BPF using video-assisted mediastinoscopy (VAM), describing the technical details.

Clinical Summary

We treated 2 patients who had left pneumonectomy for lung cancer in another center. About 1 month later, the symptoms began. The chest x-ray film showed an empty pleural cavity, and a flexible fiberoptic bronchoscope identified a fistula in both cases.

The first patient started coughing up clear sputum. The physical examination and laboratory findings showed no abnormalities. The chest computed tomographic scan measured a 17.3-mm stump (Figure 1). A standard VAM technique (the equipment and instruments have been previously described2Go) was done for closure. After a short cervicotomy, the dissection began on the anterior tracheal wall: first toward the right, we . . . [Full Text of this Article]




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Copyright © 2006 by The American Association for Thoracic Surgery.