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Large Diaphragm Defect Reconstruction Using Reverse Latissimus Dorsi Muscle Flap.
Sotatsu Fukuyama1, Masayuki Okochi1, Yuzo Komuro1
1Department of Plastic and Reconstructive Surgery, Teikyo University, Tokyo, Japan.
Plastic and Reconstructive Surgery. Global Open
|December 10, 2020
Summary
Surgical repair of bronchobiliary fistula (BBF) is challenging. A latissimus dorsi muscle flap successfully reconstructed a large diaphragm defect, offering a safe and effective solution for severe BBF cases.
Area of Science:
- Thoracic Surgery
- Surgical Reconstruction
- Hepatobiliary Surgery
Background:
- Bronchobiliary fistula (BBF) presents significant surgical challenges.
- Adhesions involving the liver, diaphragm, and lung complicate BBF treatment.
Observation:
- A 47-year-old female patient presented with cough and yellow sputum due to BBF.
- She had extensive adhesions involving the liver, diaphragm, and lung.
- A large diaphragmatic defect was noted after necessary resections.
Findings:
- Liver, diaphragm, and lung resections were performed.
- Diaphragm reconstruction utilized a pedicled reverse latissimus dorsi muscle flap.
- The flap showed no signs of necrosis, and the patient remained symptom-free with no evidence of BBF on CT scans at seven months post-surgery.
Implications:
- The pedicled reverse latissimus dorsi muscle flap is a safe and effective method for large diaphragm reconstruction.
- This surgical approach offers a reliable alternative for managing complex cases of severe bronchobiliary fistula.
- The technique facilitates easier and safer treatment of diaphragm defects in BBF patients.
