Technique of bronchial closure after pneumonectomy

Three hundred thirty-two patients had a pneumonectomy at Wythenshawe Hospital, Manchester. England, between 1974 and 1984. In all patients, the bronchus was closed with a posterior flap from the pliable membranous bronchus, leaving no stump, and with the suture line proximal to the carina. In a mean follow-up of 54 months, none of the patients had bronchopleural fistual, and 10 patients had empyema in the pneumonectomy space (3%). A fistula could not be found in any of these patients. The suture material used in closing the bronchus in all these cases was 2-0 chromic catgut, which underlines the fact that bronchial healing is not affected by the type of suture material as long as no tension exists at the suture line.