Abstract
A 61-year-old man had a right pneumonectomy for bronchogenic carcinoma. Empyema with bronchial fistula developed on the 30th postoperative day. After 46 days of tube drainage, an omental flap was drawn into the pleural cavity through the subcutaneous space from the abdominal cavity, and fixed over the fistula; the empyema cavity was obliterated with a thoracoplasty. Two months after this radical surgery, the empyema cavity was found to be less than 30 ml by computed-tomography of the chest. He was discharged 75 days after the radical surgery for empyema with bronchopleural fistula.A 50-year-old man with old tuberculous pleurisy, had removal of an empyema sac and decortication of the lung 38 days after tube drainage. However, on the 11th postoperative day he developed empyema and a bronchopleural fistula, which was successfully closed by an omental pedicle flap with thoracoplasty 48 days after the first radical surgery. He was discharged 28 days after the 2nd radical surgery for empyema with bronchopleural fistula.Transposition of an omental flap for fixation on a fistula and for filling up an empyema cavity with a thoracoplasty for reduction of a dead space is an effective treatment of empyema with bronchopleural fistula.
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