Post-pneumonectomy bronchopleural fistula: complex surgical repair for a high mortality case


Submitted: 22 December 2015
Accepted: 29 June 2016
Published: 16 November 2016
Abstract Views: 799
PDF: 470
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Authors

  • Devender Singh Department of Cardiothoracic Surgery, Kovai Medical Center and Hospital, Coimbatore, India.
  • Shegu Gilbert Department of Cardiothoracic Surgery, Kovai Medical Center and Hospital, Coimbatore, India.
  • Manohar Arumugam Department of Plastic Surgery, Kovai Medical Center and Hospital, Coimbatore, India.
  • Paulvannan Subramanian Department of General Surgery, Kovai Medical Center and Hospital, Coimbatore, India.
  • Sivakumar Mk Department of Cardiac Anesthesia, Kovai Medical Center and Hospital, Coimbatore, India.
  • Srinivasa Ramachandra Department of Cardiac Anesthesia, Kovai Medical Center and Hospital, Coimbatore, India.
Post-pneumonectomy empyema and bronchopleural fistula are dreaded complications of thoracic surgery. The associated mortality and morbidity is very high. When treatment is delayed secondary complications are more likely and survival is adversely affected. These conditions require early diagnosis and a wellplanned multi-disciplinary team approach for effective management. We present a patient with post-pneumonectomy empyema and bronchopleural fistula following pneumonectomy for post tuberculosis destroyed lung. He underwent debridement of the empyema cavity, double layer closure of the bronchial stump and reinforcement with omental flap and pectoralis major flap was used to obliterate the space. Debridement and pedicle flaps are safe and effective in the definitive management of postpneumonectomy empyema and bronchopleural fistulae.

Shegu Gilbert, Department of Cardiothoracic Surgery, Kovai Medical Center and Hospital, Coimbatore
Junior consultant, Department of cardiothoracic surgery.

Supporting Agencies

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Singh, D., Gilbert, S., Arumugam, M., Subramanian, P., Mk, S., & Ramachandra, S. (2016). Post-pneumonectomy bronchopleural fistula: complex surgical repair for a high mortality case. Chest Disease Reports, 6(1). https://doi.org/10.4081/cdr.6.5696

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