2001 Volume 15 Issue 7 Pages 785-790
A 64-year-old male patient who had undergone radical surgery for esophageal cancer was admitted to our hospital for radical resection of right lung cancer. He underwent right upper lobectomy after which a cavity of 200 ml remained at the right apex. Significant pulmonary air leakage was detected immediately after the surgery and persisted. Intrathoracic instillation of OK432 (5 times in total) or autologous blood, obliteration of the fistula with fibrin glue under thoracoscope and coverage of the fistula with an intracostal muscular flap were attempted. However, none of these procedures were effective. The filling of the cavity with a free myocutaneous flap of right abdominal rectal muscle was performed to obliterate the fistula. A pedicle of right inferior epigastric artery and vein was anastomosed to the right thoracoa crominal artery and vein, respectively. The flap was sutured to the fistula and was inserted to fill the cavity. After the filling, the patient had a good course. The filling of the cavity with a free myocutaneous flap was effective to treat a persistent pulmonopleural fistula after lung resection.
