title: Pneumoperitoneum as a valuable option in the treatment of post lower lobectomy bronchopleural fistula.
abstract: Although the incidence of post-lobectomy bronchopleural fistula has decreased over years, it remains a threatening complication in lung surgery. Once the fistula is diagnosed, treatment options are several. Conservative versus operative treatment is currently a matter of debate generally regarding timing, patient's condition and fistula's size. Although prompt resurgery is strongly suggested for early onset large fistulas, the clinical scenario may suggest a cautious conduct and conservative treatment could be advocated and repeated. Endoscopic management is now widely employed for limited, small bronchial dehiscence while pneumoperitoneum has surprisingly never been reported for this purpose, despite its potential. We report a case of a complete right lower lobe bronchial stump reopening, successfully treated by pneumoperitoneum.
authors.affiliation: Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy jacopovannucci@tiscali.i.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Vannucci
authors.affiliation: Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Scarnecchia
authors.affiliation: Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Cagini
authors.affiliation: Department of Thoracic Surgery, University of Perugia Medical School, Perugia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Puma
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001999:Bronchoscopy; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011028:Pneumoperitoneum, Artificial; D012086:Reoperation; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bronco-pleural fistula; Diaphragm; Lung cancer; Pneumoperitoneum; Pulmonary resection