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Omentoplasty for postpneumonectomy bronchopleural fistulas
H Yokomise1, Y Takahashi, K Inui
1Department of Thoracic Surgery, Kyoto University, Japan.
Summary
Pedicled omentum flap (omentoplasty) effectively treats postpneumonectomy bronchopleural fistulas, even with thoracic empyema. This surgical technique offers a successful management option for this serious thoracic complication.
Area of Science:
- General Thoracic Surgery
- Surgical Complications
- Reconstructive Surgery
Background:
- Postpneumonectomy fistula is a severe complication in thoracic surgery.
- Management of bronchopleural fistulas, especially with empyema, remains challenging.
Observation:
- A study evaluated the use of pedicled omentum for treating postpneumonectomy bronchopleural fistulas between 1984 and 1991.
- Five patients with postpneumonectomy bronchopleural fistulas, four with thoracic empyema, were treated with omentoplasty.
Findings:
- Single-stage closure covered with pedicled omentum was successful for fistulas without early infection.
- Omentoplasty was effective in managing fistulas associated with thoracic empyema, utilizing open or closed drainage.
- Open thoracotomy was employed when closed drainage failed, still achieving wound closure.
Implications:
- Omentoplasty is a viable and effective treatment for postpneumonectomy bronchopleural fistulas.
- The technique demonstrates utility even in complex cases involving thoracic empyema.
- Successful patient discharge indicates the safety and efficacy of omentoplasty in this context.