Yamaguchi A, Moro H, Iizuka M, Sugawara M, Hirono T, Miyashita K
Nihon Kyobu Geka Gakkai Zasshi. 1989 Oct;37(10):2202-6.
A 69 year-old man, who had undergone left pneumonectomy for squamous cell carcinoma of the lung 21 months ago, was admitted with a high temperature and chest pain. A diagnosis of empyema was made, and a chest tube was inserted for drainage. Bronchopleural fistula was not noted. Noticing that food was leaking through the drainage tube, a diagnosis of esophagopleural fistula was made radiologically. Surgery was done in October, 1987, after irrigating an empyema space for two months. The fistula was approximately 4 cm below the carina, and it was closed directly. The omentum was sutured around the closed site to reinforce and obliterate the empyema space. Furthermore, additional thoracoplasty was done because the cavity was too large to close only with the omentum. The postoperative course was uneventful. He was able to eat specially prepared foods within 4 weeks, and was discharged on the 60th day after the operation. This patient could possibly be the first case who had undergone an omental flap for the closure of a postpneumonectomy esophagopleural fistula.
一名69岁男性，21个月前因肺鳞状细胞癌接受了左肺切除术，现因高热和胸痛入院。诊断为脓胸，并插入胸管进行引流。未发现支气管胸膜瘘。注意到食物通过引流管漏出，经放射学诊断为食管胸膜瘘。在对脓腔进行两个月的冲洗后，于1987年10月进行了手术。瘘口位于隆突下方约4厘米处，直接进行了缝合。将大网膜缝合在闭合部位周围，以加固并消除脓腔。此外，由于脓腔过大，仅用大网膜无法闭合，因此还进行了额外的胸廓成形术。术后过程顺利。他在4周内能够进食特制食物，并于术后第60天出院。该患者可能是首例采用大网膜瓣闭合肺切除术后食管胸膜瘘的病例。
