Ginsberg R J, Pearson F G, Cooper J D, Spratt E, Deslauriers J, Goldberg M, Henderson R D, Jones D
Division of Thoracic Surgery, University of Toronto, Ontario, Canada.
Ann Thorac Surg. 1989 Feb;47(2):231-5. doi: 10.1016/0003-4975(89)90276-2.
Thirteen patients with postpneumonectomy bronchopleural fistula occurring 4 months to 10 years after the initial operation have been treated with a transsternal transpericardial approach after the associated empyema had been treated by either tube thoracostomy or open-window thoracostomy. In 10 patients, there were contraindications to using an ipsilateral transthoracic approach. In 10 of the 13 patients, the procedure was successful. Three fistulas recurred; two were quite small, one of them closing spontaneously within 6 months. There were no deaths or clinically significant morbidity related to the transsternal approach. We have found this technique to be most applicable in those patients in whom other procedures have failed to resolve the problem. The technique is relatively simple and safe.
13例肺切除术后支气管胸膜瘘患者，瘘发生于初次手术后4个月至10年，在通过胸腔闭式引流或胸廓开窗术治疗相关脓胸后，采用经胸骨经心包途径进行治疗。10例患者存在使用同侧经胸途径的禁忌证。13例患者中有10例手术成功。3例瘘复发；2例瘘口非常小，其中1例在6个月内自行闭合。未发生与经胸骨途径相关的死亡或具有临床意义的并发症。我们发现该技术最适用于其他方法未能解决问题的患者。该技术相对简单且安全。
