title: Bronchopleural fistula after pneumonectomy: interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.
abstract: Post-pneumonectomy bronchopleural fistula (BPF) remains a rare but often life-threatening complication and therapeutic challenge. Traditional surgical procedures include chronic open drainage, attempts at direct stump closure, thoracoplasty with or without chest wall muscle transposition and trans-sternal bronchial closure. We describe a case with successful closure of a chronic BPF after pneumonectomy by intrathoracic transposition of a pedicled latissimus dorsi muscle flap circumferentially fixed on the surrounding pleural tissue under continuous video-assisted thoracoscopic overview. The postoperative course was without complications; no tumour, empyema or fistula re-occurred. In this article we want to present the potential advantages of video-assisted thoracoscopic support and interdisciplinary teamwork to improve the outcome of patients with BPFs after pneumonectomy.
authors.affiliation: Department of Plastic and Aesthetic Surgery, Florence-Nightingale Hospital, Kaiserswerther Diakonie, Kreuzbergstrasse 79, 40489 Duesseldorf, Germany. Electronic address: woltera@fnk.de.
authors.forename: A
authors.initials: A
authors.lastname: Wolter
authors.forename: T
authors.initials: T
authors.lastname: Scholz
authors.forename: J
authors.initials: J
authors.lastname: Diedrichson
authors.forename: A
authors.initials: A
authors.lastname: Arens-Landwehr
authors.forename: R
authors.initials: R
authors.lastname: Schroeder-Finckh
authors.forename: J
authors.initials: J
authors.lastname: Liebau
mesh_terms: D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects*; D064171:Superficial Back Muscles; D013524:Surgical Flaps; D020775:Thoracic Surgery, Video-Assisted
keywords: M. latissimus dorsi; Post-pneumonectomy bronchopleural fistula; VATS; Video-assisted thoracoscopy; Videothoracoscopy