Closure of a large bronchial fistula with a latissimus dorsi myocutaneous flap |
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Authors: | Naoya Katsuragi Yutsuki Nakajima Yuji Shiraishi Masahiro Hashizume and Nobumasa Takahashi |
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Institution: | (1) Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan;(2) Section of Chest Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, 204-8522 Tokyo, Japan |
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Abstract: | We describe a case of a large bronchial fistula and empyema after right upper lobectomy that was treated successfully with
open window thoracostomy followed by a latissimus dorsi myocutaneous flap and limited thoracoplasty. A latissimus dorsi myocutaneous
flap can provide immediate airtight closure of a large bronchial fistula, allowing lavage and curettage of the empyema cavity
to reduce the chance of postoperative infection. An important aspect of this technique is that the deepithelialized skin side
rather than muscle is sutured to an opening of the bronchus. As compared with other techniques, a latissimus dorsi myocutaneous
flap is superior in that it requires a single incision and does not require an intraop-erative change of position. In addition,
the technique causes little dysfunction of the chest and shoulder and preserves the vascular supply to ensure the viability
of the flap even if it was divided in a previous operation. |
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Keywords: | bronchial fistula empyema lung cancer myocutaneous flap open window thoracostomy |
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