Fenestration without rib resection for postoperative bronchopleural fistula

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Innovation

Background:

• Bronchopleural fistula necessitates fenestration to prevent life-threatening complications.
• Conventional fenestration often involves significant incisions (9-cm mean) and rib resection.

Purpose of the Study:

• To evaluate a novel fenestration technique for bronchopleural fistula management.
• To assess the feasibility and patient outcomes of fenestration without rib resection.

Main Methods:

• A 73-year-old male with lung cancer and combined pulmonary fibrosis/emphysema underwent right lower lobectomy.
• Developed postoperative bronchopleural fistula on day 20.
• Emergency fenestration was performed without rib resection using a Lap-protector.

Main Results:

• The patient experienced minimal postoperative pain.
• Effective control of thoracic cavity infection was achieved.
• Routine activities were unaffected, despite tumor recurrence leading to abandonment of thoracic cavity closure.
• No complications such as pneumonia were observed.

Conclusions:

• Fenestration without rib resection using a Lap-protector is a convenient and less painful alternative to conventional methods.
• This technique provides effective infection control for postoperative bronchopleural fistula.
• It preserves patient comfort and functional status.