title: [Therapy of parenchyma and bronchus fistula in chronic pleural empyema and the remaining empyema cavity].
abstract: The peripheral bronchial fistula, which is not visible by direct endoscopic examination, is closed by endoscopic application of fibrin glue. Sometimes only conservative therapy with irrigation of the pleural space is sufficient and effective. The postlobectomy fistula of the bronchus stump is treated by preoperative puncture and irrigation of the pleural space, followed by a corrective reamputation of the stump of the bronchus or a sleeve resection with end-to-end anastomosis. The post-pneumonectomy fistula has to be corrected by preoperative irrigation of the pleural space and a corrective second amputation by an extrapleural transmediastinal procedure. Sometimes it is necessary to use an opposite posterior access. An alternative is to cover the stump by an intercostal muscle flap without directly closing the fistula by suture. The remaining pleural space must be obliterated by using an additive pedunculated muscle flap of the thoracic wall.
authors.affiliation: Krankenanstalten der Stadt Köln.
authors.forename: D
authors.initials: D
authors.lastname: Zeidler
mesh_terms: D001983:Bronchial Fistula / Q000601:surgery*; D002908:Chronic Disease; D016724:Empyema, Pleural / Q000601:surgery*; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D005402:Fistula / Q000601:surgery*; D006801:Humans; D010995:Pleural Diseases / Q000601:surgery*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013536:Suture Techniques; D007507:Therapeutic Irrigation
chemical_list: D015718:Fibrin Tissue Adhesive
vernacular_title: Therapie der Parenchym- und Bronchusfistel beim chronischen Pleuraempyem und der Empyemresthöhle.