Ozaki S, Nakanishi R, Onimura S, Tokunaga H, Yasumoto K
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushyu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 May;44(5):687-90.
The omental wrapping is a method of the choice for empyema with bronchopleural fistula. A 71-year-old woman, who had undergone graft replacement for the aneurysm of the descending thoracic aorta, underwent left pneumonectomy for lung abscess. Two months after surgery, the bronchopleural fistula in the stump was presented and successfully repaired by omentopexy. When anastomotic aneurysm rupture of the graft was presented one year later, the management was successful because mortal bleeding was prevented by the omental pedicle flap in the left thoracic cavity. Though we removed the omental flap with hematoma, the fistula didn't recurred. The omentum facilitates the healing of bronchopleural fistula in the early phase after surgery, but the healing course in the extended phase had not have any trouble without omental vascularization.
网膜包裹术是治疗脓胸合并支气管胸膜瘘的首选方法。一名71岁女性因降主动脉瘤行人工血管置换术，后因肺脓肿行左肺切除术。术后两个月，残端出现支气管胸膜瘘，通过网膜固定术成功修复。一年后出现人工血管吻合口动脉瘤破裂，由于左侧胸腔的网膜蒂瓣防止了致命性出血，治疗成功。尽管我们切除了带有血肿的网膜瓣，但瘘并未复发。网膜有助于术后早期支气管胸膜瘘的愈合，但在没有网膜血管化的情况下，延长阶段的愈合过程并未出现任何问题。
