2025 Volume 39 Issue 1 Pages 25-29
Covering a bronchial stump with a free pericardial fat pad (FPFP) may be a useful preventive measure against the development of a bronchopleural fistula (BPF), a serious postoperative complication. A 66-year-old woman underwent a video-assisted thoracoscopic right lower lobectomy for lung adenocarcinoma. During the procedure, the bronchial stump was covered with an FPFP. On postoperative day 21, she presented with respiratory distress, and examination revealed right pneumothorax. We immediately inserted a chest drainage tube; however, because of a severe air leakage, her respiratory status did not improve. The patient was intubated, and the air leakage disappeared shortly thereafter. Subsequently, her respiratory status stabilized. Bronchoscopy revealed a BPF, which was closed with an FPFP from the thoracic side. Displacement of the FPFP occurred during the intubation process. The patient was treated conservatively with trafermin drops around the fistula under bronchoscopy. On hospital day 70, complete healing of the fistula was observed. Although an FPFP did not prevent the development of a BPF, in this case, FPFP prevented the progression of the BPF, and as a result, the fistula healed completely.
