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Bronchial stump coverage and postpneumonectomy bronchopleural fistula
Michael Lindner1, Alexander Hapfelmeier, Alicia Morresi-Hauf
1Department of Thoracic Surgery, Asklepios Fachkliniken München-Gauting, Gauting, Germany. michael.lindner@med.uni-muenchen.de
Asian Cardiovascular & Thoracic Annals
|October 16, 2010
Summary
Proximal pericardial fat pad coverage of the bronchial stump is a safe and effective method to prevent postpneumonectomy bronchopleural fistula. This technique is comparable to pleural covering in preventing this serious complication.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Bronchopleural fistula (BPF) is a serious complication after pneumonectomy.
- Coverage of the bronchial stump is recommended to prevent BPF, particularly in patients receiving neoadjuvant or adjuvant chemotherapy/radiochemotherapy.
Purpose of the Study:
- To compare the outcomes of proximal pericardial fat pad coverage versus coverage with pleura and surrounding tissues for preventing postpneumonectomy bronchopleural fistula.
Main Methods:
- Retrospective analysis of 243 patients undergoing pneumonectomy.
- Comparison of BPF rates between pericardial fat pad coverage and pleural covering groups.
Main Results:
- BPF occurred in 4.9% of patients with pericardial fat pad coverage (7/143) and 6.0% with pleural covering (6/100).
- Advanced T stage and carcinomatous lymphangiosis at the resection margin were independent risk factors for BPF.
- No significant differences in comorbidities or risk factors were observed between the groups.
Conclusions:
- Proximal pericardial fat pad coverage is a safe and feasible technique for bronchial stump reinforcement.
- Pericardial fat pad coverage is comparable to pleural covering in preventing postpneumonectomy bronchopleural fistula.
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