title: Post-pneumonectomy broncho-pleural fistula successfully closed by open-window thoracostomy associated with V.A.C. therapy.
abstract: Broncho-pleural fistula (BPF), is a dramatic complication that may occur after lung resection. The treatment is challenging due to its high rate of morbidity and mortality. Herein, a case of BPF associated with empyema, occurred in an elderly patient who had undergone to left pneumonectomy for non-small cell lung cancer (NSCLC), is reported. After various treatments including chest drainage and endoscopic procedures, BPF was successfully closed by open-window thoracotomy associated with vacuum assisted closure (V.A.C.) device therapy. The authors conclude that V.A.C. is a convenient and safe measure in the management of empyema with BPF. Moreover, in similar clinical contexts, V.A.C. may be the only option available that may assure the survival of the patient and the avoiding any later-phases of residual cavity.
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: laper@libero.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Laperuta
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: milena.napolitano@yahoo.it.
authors.forename: Filomena
authors.initials: F
authors.lastname: Napolitano
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: avatrella@unisa.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vatrella
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: vdcres@alice.it.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Di Crescenzo
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: ancortese@unisa.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cortese
authors.affiliation: Department of Medicine and Surgery, Unit of Maxillofacial Surgery, University of Salerno, Salerno, Italy. Electronic address: vdicrescenzo@unisa.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Crescenzo
mesh_terms: D000368:Aged; D001983:Bronchial Fistula / Q000150:complications / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D016724:Empyema, Pleural / Q000150:complications; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010995:Pleural Diseases / Q000150:complications / Q000601:surgery*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000601:surgery*; D013907:Thoracostomy / Q000379:methods*
keywords: Open-window thoracostomy; Post-pneumonectomy broncho-pleural fistula; Vacuum assisted closure therapy