title: Management of a complicated pulmonary fistula caused by lung cancer using a fibrin glue-soaked polyglycolic acid sheet covered with an intercostal muscle flap.
abstract: Pulmonary fistulas caused by tumours are very fragile and difficult to suture directly. It is impossible to close pulmonary fistulas with tissue sealants when massive air leakage occurs in the low pressure of the respiratory tract. A 73-year-old man with a pneumothorax caused by lung cancer had suffered a persistent massive air leakage for more than one month. We used a fibrin glue-soaked polyglycolic acid (PGA) sheet for sealing the complicated fistula. In addition, the visceral pleura of the fistula was wrapped with the pedicle of an intercostal muscle (ICM) flap to prevent massive air leakage. The pneumothorax did not reappear after surgery. Thus, a fibrin glue-soaked PGA sheet covered with an ICM flap was effective for sealing an intractable air-leaking fistula caused by lung cancer.
authors.affiliation: Department of Thoracic Cardiovascular Surgery, Kansai Medical University Hospital, Kansai Medical University, Hrakata, Osaka, Japan. maniwat@hirakata.kmu.ac.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Maniwa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007366:Intercostal Muscles / Q000637:transplantation*; D008171:Lung Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D010994:Pleura / Q000601:surgery; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery; D011100:Polyglycolic Acid / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D011100:Polyglycolic Acid