One successful primary closure case of bronchopleural fistula after pneumonectomy by a new method

One case of successful primary closure of a bronchopleural fistula (BPF) after right pneumonectomy by sealing from both inside the chest cavity and bronchus is reported. The patient was a 47-year-old man who underwent right pneumonectomy due to right lung total collapse and atelectasis which was long-term compressed by a huge cyst inside the right chest cavity. A BPF was found on day 20 after surgery. A thoracotomy approach was performed because it was difficult to find an appropriate location for close drainage. Once the effusion and bloody coagulum was cleaned up from the right chest cavity, it was still difficult to find the bronchial stump because of the thick pleural fibrous membranes, and no visible fistula was found. Inside the chest cavity, a bright spot could be seen when the bronchoscope was inserted to the right bronchial stump. Anastomotic glue (OB Glue) was smeared on the bright spot and NEOVEIL (Gunze Co., Tokyo, Japan) was used to cover and reinforce the area. Meanwhile OB Glue (Gzbme Co., Guangzhou, China) was placed on the bronchial stump by bronchoscope. Closed drainage was performed after the operation. The patient recovered well having an uncomplicated postoperative course and was discharged 7 days after the treatment.