Myrmel T, Almdahl S M
Kirurgisk avdeling Regionsykehuset i Tromsø.
Tidsskr Nor Laegeforen. 1995 Nov 30;115(29):3627-8.
A bronchopleural fistula after pneumonectomy is a serious complication, and successful healing is a therapeutic challenge. Increasing evidence indicates that closing of the fistula combined with wrapping the bronchus with omentum (omentoplasty) can secure permanent healing in the majority of cases. The omentum is highly vascularized, and has angiogenetic and anti-inflammatory properties. We describe two patients with bronchopleural fistulas after surgery for lung cancer. The fistulas were diagnosed respectively one and fifteen months after operation. Both were treated successfully with antibiotics, surgical debridement, secondary closure and wrapping of the fistulas with omentum transposed from the abdomen with its attachment to the right gastroepiploic artery preserved.
肺切除术后支气管胸膜瘘是一种严重的并发症,成功治愈是一项治疗挑战。越来越多的证据表明,瘘管闭合联合用大网膜包裹支气管(大网膜成形术)可使大多数病例获得永久性愈合。大网膜血管丰富,具有血管生成和抗炎特性。我们描述了两名肺癌手术后发生支气管胸膜瘘的患者。瘘管分别在术后1个月和15个月被诊断出来。两名患者均通过使用抗生素、手术清创、二期缝合以及用保留其与右胃网膜动脉相连的来自腹部的大网膜包裹瘘管而成功治愈。