The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Successful closure of a post pneumonectomy bronchial fistula using a free costal cartilage flap: Report of a case
Takuya WatanabeKatsumi NakamaeOsamu KawanoIchiro FukaiMotoki Yano
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2015 Volume 29 Issue 5 Pages 622-626

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Abstract

A 69-year-old male with diabetes mellitus developed a bronchial fistula after right pneumonectomy. Direct stump closure by wrapping with an intercostal muscle flap failed, resulting in fenestration. The fistula deteriorated with a maximal diameter of 3 cm over a one-year period. Direct suturing was not possible as the fistula was large, and we used a free costal cartilage as a tight seal for it. The free costal cartilage, harvested from the sixth rib, was adjusted to the size of the fistula and fixed to be airtight by interrupted suturing. An omentum flap, prepared in advance, was attached to the cartilage, and the whole procedure was completed by thoracoplasty. His postoperative course was uneventful, resulting in complete closure, which was ascertained by bronchoscopy eight months after the operation. This case shows that it is possible to use a free costal cartilage flap for successful closure of a large bronchial fistula.

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© 2015 The Japanese Association for Chest Surgery
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