1994 Volume 8 Issue 7 Pages 789-794
To prevent bronchial fistulas after operations for primary lung cancer since 1992, we have wrapped bronchial stumps protectively with intercostal muscle pedicles in operations on poor risk patients : 1. right pneumonectomy, 2. right middle & lower lobectomy and lower lobectomy, 3. right sleeve lobectomy and pneumonectomy, 4. presence of DM, TIP, renal failure, etc. 5. post systemic chemotherapy. Of the 116 operations for primary lung cancer, 18 bronchial stumps (15.5%) were wrapped with intercostal muscle pedicles. The average age of the 18 patients was 62.2 years. The operations were three right pneumonectomies, three right middle & lower lobectomies, seven right lower lobectomies, two right sleeve upper & middle lobectomies, two right sleeve upper lobectomies, and one left lower lobectomy. The methods of closure of the bronchial stumps were automatic stapling in 13 patients and manual suturing in five. There have been no fistulas in those bronchial stumps wrapped with intercostal muscle pedicles during the past one year and eight months.
Wrapping bronchial stumps with intercostal musle pedicles is inferior to omentopexy in the prevention of inflammation, but it is a useful, easy and quick method which can be applied at the time of pulmonary resection.
