Transposition of modified latissimus dorsi musculocutaneous flap in the treatment of persistent bronchopleural fistula after posterolateral incision |
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Authors: | Takaomi Hanaoka Yutsuki Nakajima Yuji Shiraishi Naoya Katsuragi and Hidehiro Konno |
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Institution: | (1) From the Department of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan;(2) Section of Chest Surgery, Azumi General Hospital, 3207-1 Ikeda, Ikedamachi, Kitaazumi-gun, 399-8695 Nagano, Japan |
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Abstract: | The condition of a 51-year-old man was complicated with empyema and bronchopleural fistula (BPF) after left upper lobectomy
and thoracoplasty for pulmonary aspergillosis. On the postoperative day (POD) 12, the opened bronchial stump was directly
closed and covered with a pedicled pectoralis major muscle flap. On POD 66, an open-window thoracostomy was done, because
of empyema with Pseudomonas aeruginosa. Two years later, we could fill the empyema cavity, and close the multiple BPFs with the transposition of a modified pedicled
musculocutaneous (MC) flap and the additional thoracoplasty to gain good quality of life. Although the MC flap was a proximal
part of the latissimus dorsi muscle, which was dissected along the posterolateral incision of the first operation, it could
be successfully transplanted to cover the BPFs in the open-window. In some patients with a small open-window on the upper
anterior chest wall, the pedicled proximal latissimus dorsi MC flap may be very useful for treating persistent BPFs even after
a standard posterolateral incision. |
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Keywords: | pedicled proximal latissimus dorsi musculocutaneous flap postoperative empyema pulmonary aspergillosis |
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