Omental pedicle flap with rectus abdominis myocutaneous flap for bronchial fistula after radiation therapy ; a case report

Abstract

The management of bronchial fistula after radiation therapy remains a problem area in the field of thoracic surgiry.
A 60-year-old female underwent rigth radical mastectomy and radiation therapy for right breast cancer 28 years ago. Ten years after operation, she developed a bronchial fistula in the anterior chest. Several surgeons in other hospitals failed to close the bronchial fistula.
We performrd an omental pedicle flap closure with a rectus abdominis myocutaneous flap for the bronchial fistula on 21 August in 1991.
Postoperarive complications were abscess in abdominal wall and in part of the transplanted flap, peritonitis, and pneumonia.
But the operative wound healed, and the bronchial fistula closed successfully 2 months later.
Omental pedicle flap closure with rectus abdominis myocutaneous flap should be effective for intractable bronchial fistula after radiation.