Tanaka Hirokazu, Kou Yuuki, Yamazaki Nobuhisa, Sakaguchi Yasuto, Sonobe Makoto
Department of Thoractic Surgery, Osaka Red Cross Hospital, Osaka, Japan.
Kyobu Geka. 2024 Jul;77(7):550-552.
A 67-year-old male was admitted to our hospital for the treatment of pyothorax due to bronchopleural fistula at right main bronchus after pneumonectomy for lung cancer( squamous cell carcinoma, pathological stageⅢB). After tube drainage and fenestration, we performed operation to close large diameter fistula, that was almost fully opened stump of the right main bronchus. Omental flap was sutured roughly to the fistula with four stiches and inserted into the bronchus lumen, and covered with latissimus dorsi muscle flap to fix omental pedicle flap and additionally performed thoracoplasty to close the residual space of the pleural cavity. Fistula at the stump became airtight after operation and pyothorax was cured, so our method was thought to be available to close large diameter bronchopleural fistula with omental pedicle flap.
一名67岁男性因肺癌（鳞状细胞癌，病理分期ⅢB期）肺切除术后右主支气管支气管胸膜瘘导致脓胸入住我院治疗。在进行胸腔闭式引流和开窗术后，我们对右主支气管几乎完全开放的大口径瘘口进行了闭合手术。将大网膜瓣用4针粗线缝合至瘘口并插入支气管腔内，并用背阔肌瓣覆盖以固定大网膜蒂瓣，另外还进行了胸廓成形术以闭合胸腔残余间隙。术后残端瘘口密闭，脓胸治愈，因此我们认为用大网膜蒂瓣闭合大口径支气管胸膜瘘的方法是可行的。
