Closure of acute bronchial stump insufficiency with a musculus latissimus dorsi flap

We describe a successful closure of an acute bronchial stump insufficiency after pneumonectomy by intrathoracic transposition of the pedunculated latissimus dorsi muscle: A 56-year-old patient with a necrotizing bronchial carcinoma developed a stump insufficiency after right pneumonectomy. Repeated resection and renewed closure of the completely dehiscent stump was not possible, as the stem bronchus had been separated close to the tracheal bifurcation in the preceding operation. Therefore we transposed the pedunculated musculus latissimus dorsi into the thoracic cavity. The closure of the bronchial stump insufficiency was achieved by fixation of the muscle on to the open stump and surrounding tissue of the mediastinal pleura with fibrin glue. The postoperative course was without complications, no further insufficiency or empyema developed.