The value of Asamura-Naruke type main bronchus stump closure and pleuro-pericardial flap covering by own method to avoid broncho-pleural fistula (BPF).

1. Authors present an "old-new" main bronchus closure procedure, which combines the Sweet's and Overholt's methods, recommended by Asamura-Naruke. 2. The A-N procedure decreased the prevalence of BPF from 2.8% to 0.09% in case of thoracotomy and from 9.5% to 2.4% in case of pneumonectomy compared 2 different stump-closing types. 3. There was not BPF in the "covered subgroup" (0%/92 PN) recommended by us, independent of the closing types. 4. All bronchial stumps closed like A-N and covered by our method (0% BPF/62 PN) healed.