[Intrathoracic omentoplasty in the treatment of pleural cavity secondary to stabilized bronchial fistula].
OBJECTIVE
The aim of this paper was to verify the effectiveness of omentoplasty, either single or associated to other procedures, in the treatment of permanent fistula of the main bronchi.


METHODS
The authors report their experience of 10 intrathoracic omentoplasties for pleural cavity from fistula of the main bronchus. In 2 cases a single omentoplasty was performed, while 8 patients had an associated procedure (4 thoracoplasties, 7 mioplasties and 2 mammoplasties). In 8 cases the vascular pedicle used for the omentum was the right gastroepiploic artery, and the left one in the remaining 2 patients. The omentum was mobilized through an opening in the diaphragm and anchored to the bronchial stump. In the combined plasties it was then covered by chest wall (thoracoplasty), muscles (mioplasty) or mammary gland (mammoplasty); in the single omentoplasty omentum was also sutured to the chest wall. Indication for combined procedures was high bacterial contamination of the pleural cavity; single omentoplasty was performed for small cavities, where other procedures had previously failed. Only in the single omentoplasties a pre-operative selective angiography of the gastroepiploic arteries was performed.


RESULTS
Such procedures were resolutive in 9 patients; 1 needed an endoscopic application of fibrin glue.


CONCLUSIONS
Intrathoracic omentoplasty is an effective procedure to solve both pleural cavity and stabilized bronchial fistula, mostly because of plastic and immunologic features of the omentum.
Politi
L
L
UO Chirurgia Toracica, Ospedale Civile di Verona, Verona, Italy.
Scanagatta
P
P
Salani
A
A
Montinaro
F
F
Turini
A
A
Crisci
C
C
D001983:Bronchial Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D001999:Bronchoscopy; D016724:Empyema, Pleural / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009852:Omentum / Q000637:transplantation*; D035422:Pleural Cavity; D013905:Thoracoplasty; D014057:Tomography, X-Ray Computed