[Omentoplasty in bronchopleural fistulas after pneumonectomy]

A bronchopleural fistula after pneumonectomy is a serious complication, and successful healing is a therapeutic challenge. Increasing evidence indicates that closing of the fistula combined with wrapping the bronchus with omentum (omentoplasty) can secure permanent healing in the majority of cases. The omentum is highly vascularized, and has angiogenetic and anti-inflammatory properties. We describe two patients with bronchopleural fistulas after surgery for lung cancer. The fistulas were diagnosed respectively one and fifteen months after operation. Both were treated successfully with antibiotics, surgical debridement, secondary closure and wrapping of the fistulas with omentum transposed from the abdomen with its attachment to the right gastroepiploic artery preserved.