[Routine broncho-myo-plasty after pneumonectomy]

Bronchopleural fistula is certainly the most important and specific complication following total pneumonectomy. In order to reduce this risk a systematic protection of bronchial suture by means of muscular flap transposition is suggested. The authors report 15 cases of total pneumonectomy for lung cancer at different localization. In all the patients a bronchomuscular plasty was used to protect the bronchial suture. The anterolateral body of latissimus dorsi, when it was possible, was preferred for the following reasons: 1) it makes the suture of the main bronchus greatly resistant; 2) it makes easier the obliteration of the pleural cavity; 3) its transposition is rapid and easy. In only one case a diaphragmatic flap was transposed together with its vascular and nervous system giving rise to a phrenic paralysis. Although few cases are reported, the results are successful and encourage the application of this procedure in future.