Bronchopleural fistula after pneumonectomy: Interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy.

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

PubMedID: 23587680

Wolter A, Scholz T, Diedrichson J, Arens-Landwehr A, Schroeder-Finckh R, Liebau J. Bronchopleural fistula after pneumonectomy: Interdisciplinary surgical closure by an ipsilateral pedicled latissimus dorsi flap supported by video-assisted thoracoscopy. J Plast Reconstr Aesthet Surg. 2013;.
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.