Elswick Sarah M, Sharaf Basel, Hammoudeh Ziyad S, Saeed Ali I, Edell Eric S, Midthun David E, Blackmon Shanda H
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Ann Thorac Surg. 2017 Jul;104(1):e1-e3. doi: 10.1016/j.athoracsur.2017.01.104.
The management of bronchopleural fistulas can be challenging. The initial treatment is usually conservative, but operative intervention with transposition of vascularized pedicled flaps may be required in refractory cases. We present the case of a 67-year-old man with stage IIIa squamous cell carcinoma of the lung who underwent a lower and middle bilobectomy after receiving neoadjuvant chemoradiation. His postoperative course was complicated by empyema and a bronchopleural fistula. Because of difficulty accessing the fistula, endobronchial-guided vascularized tissue flaps were successfully used to close the fistula.
支气管胸膜瘘的处理颇具挑战性。初始治疗通常较为保守，但对于难治性病例，可能需要采用带血管蒂皮瓣转位的手术干预。我们报告一例67岁男性，患有Ⅲa期肺鳞状细胞癌，在接受新辅助放化疗后行下叶和中叶双肺叶切除术。他的术后病程因脓胸和支气管胸膜瘘而复杂化。由于难以接近瘘口，经支气管引导下成功使用带血管组织瓣封闭了瘘口。
