Abstract
BackgroundA bronchopleural fistula (BPF) can lead to empyema and death after pulmonary resection. A minor leakage from a BPF has been reported to be successfully closed endobronchially, although thoracoplasty is usually needed.Case presentationA case of successful thoracoscopic BPF closure using an omental flap in a 74-year-old man with emphysema who developed a BPF after right lower lobectomy for lung cancer is reported. Reoperation was performed to close the BPF using an omental flap. After successful closure of the BPF, the empyema resolved with intravenous antibiotics.ConclusionsThoracoscopic single-stage omentoplasty without thoracotomy might be a useful treatment method when a BPF is diagnosed early.
Highlights
A bronchopleural fistula (BPF) can lead to empyema and death after pulmonary resection
Case presentation A 74-year-old man was admitted for right lower lobectomy with lower mediastinal and hilar lymph node dissection for squamous cell carcinoma
With the patient back in the lateral position, the omental flap was led through the anterior mediastinum below the sternum and sutured above and below the bronchial fistula using two nonabsorbable mattress sutures
Summary
A bronchopleural fistula (BPF) is one of the most difficult complications after major lung surgery because it can decrease patients’ activities and quality of life and predispose them to severe infections, such as pyothorax and pneumonia, which have a high mortality. Case presentation A 74-year-old man was admitted for right lower lobectomy with lower mediastinal and hilar lymph node dissection for squamous cell carcinoma. He had pulmonary emphysema secondary to smoking more than 50 pack-years. With the patient back in the lateral position, the omental flap was led through the anterior mediastinum below the sternum and sutured above and below the bronchial fistula using two nonabsorbable mattress sutures. It was fixed using three sutures to the parietal pleura without using fibrin sealant. The patient complained of anorexia and pain for several days after
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