Repair of postpneumonectomy bronchopleural fistula using pedicled pericardial flap supported by fibrin glue

Abstract

Effective closure of the postpneumonectomy bronchopleural fistula (PBF) with the use of different techniques still remains a challenge for thoracic surgeons. The aim of this study was to evaluate the efficacy of modified method of PBF closure using pedicled pericardial flap (PPF) supported by fibrin glue (FG). The efficacy of the late PBF closure with the use of two surgical methods was compared. In 10 patients, the edges of the PBF were covered with FG and PPF. In the second group of nine patients, myoplasty was used to close the bronchial fistula. Postsurgical follow-up was for 1 year. In the first group, the healing of the fistula was achieved in 100% of the cases, whereas in the second, myoplasty group, healing was achieved in only 66·67% of the cases. The number of complications was similar in both groups. Pericardial flap supported by fibrin glue can be an effective method adjunctive to the treatment of PBF in selected patients.

Management of Postpneumonectomy Bronchopleural Fistulae

“…This patient developed pericarditis and heart failure in the postoperative period, and discharged home after treatment. Jablonski et al reported that pericardial flap and fibrin glue were superior to omentopexy and myoplasty [9,14]. We believe that opening the pericardium within an infected site will increase the risk of pericarditis.…”

“…Therefore PPBPF, which may have severe consequences, requires a good treatment plan. The preferred treatment in PPBPF remains controversial [6][7][8][9][10][11]14,15]. The general tendency in our series was, if the bronchus would not be revised, to perform an OWT as soon as possible after the PPBPF was fixed with a tube thoracostomy.…”