title: [Successful two-stage approach to treating excessive hemorrhage from pulmonary arterial stump in post-lobectomy bronchopleural fistula].
abstract: A 62-year-old man underwent right lower lobectomy for adenocarcinoma (pT2N0M0) and nine days later, a bronchopleural fistula with empyema was evident. Six weeks following the lobectomy, excessive hemorrhage from the site of chest drainage and hemoptysis were noted. The bleeding and empyema were controlled by a two-stage approach. Anterior transpericardial approach was first made through the median sternotomy to clamp the right main pulmonary artery and then postero-lateral thoracotomy was conducted for the bronchopleural fistula with empyema. The right bronchial stump was covered with a pedicled muscle flap and pseudomonas aeruginosa, always positive in drainage effusion, consequently disappeared. The patient was discharged with a closed bronchus 4 months following the operation.
authors.affiliation: Department of Surgery, Sendai Kousei Hospital, Miyagi, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kanda
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Handa
authors.forename: M
authors.initials: M
authors.lastname: Sagawa
authors.forename: S
authors.initials: S
authors.lastname: Fujimura
mesh_terms: D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D016724:Empyema, Pleural / Q000209:etiology / Q000601:surgery; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D011651:Pulmonary Artery / Q000601:surgery*; D013510:Pulmonary Surgical Procedures / Q000379:methods; D012086:Reoperation