Thoracoscopic Closure of Alveolar Pleural Fistula by Application of Pleural Flap and Polymeric Sealant

Persistent air leaks due to alveolar pleural fistula following lung resection were a frustrating clinical condition for patients and clinicians, associated with a prolonged hospital stay and increased morbidity. Several surgical strategies have been reported over the years for the closure of alveolar fistula, but the best treatment was still debated. Herein, we reported the clinical case of a patient who experienced a persistent air leak due to alveolar-pleural fistula following thoracoscopic right upper lobectomy for the management of early lung cancer. The fistula was successfully closed by thoracoscopic application of a pleural flap and polymeric sealant. Our new strategy could turn out to be useful for surgeons when standard procedures for management of APF were unfeasible or difficult to perform. Obviously, our impression should be validated by future large studies in a prospective manner.