• Journal of Chest Surgery
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• v.15 no.3
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• pp.295-298
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• 1982

Persistent bronchopleural fistula still presents a troublesome therapeutic challenge and demands an aggressive approach when conventional measures fail. Empyema associated bronchopleural fistula developed after resectional surgery and their primary diseases were lung abscess in one case, bronchiectasis in two cases. Three cases of postpneumonectomy empyema associated bronchopleural fistula were treated surgically with a pedicled intercostal muscle grafting and concomittent thoracoplasty. After the procedure, patients had no recurrent symptoms or signs of bronchopleural fistula and discharged from hospital with improved condition.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.566-571
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• 1990

The Bronchial stump disruption in bronchopleural fistula with empyema thoracis after pneumonectomy has remained one of the most dreaded complications of thoracic surgery. Management of chronic bronchopleural fistula still poses a therapeutic dilemma in spite of various surgical techniques that have been attempted to control this complication. Only recently, transsternal transpericardial approach for repair of the postpneumonectomy bronchopleural fistula has been utilized in some cases. The patient was a 31 year-old woman who was admitted to our hospital on August 18th, 1989 due to right postpneumonectomy bronchopleural fistula with empyema thoracis for 5 years since she had undergone right pneumonectomy due to pulmonary tuberculosis at E-hospital in 1984. Transsternal transpericardial closure of the fistula was employed and then the thoracic catheter was removed two months later, after the empyema cavity was sterilized by the Clagett method. So, we think this surgical technique is a relatively simple and effective method to the control of chronic postpneumonectomy bronchopleural fistula with empyema thoracis.

• Archives of Reconstructive Microsurgery
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• v.23 no.1
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• pp.21-24
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• 2014

Bronchopleural fistula is an unnatural communication between the bronchial tree and pleural space. Closure of the bronchial stump using various muscular flaps has been previously reported. There have been few reports on treatment of large defects with bronchopleural fistula accompanied by surrounding muscle injury. We report on our experience with two patients suffering from large defect with bronchopleural fistula, who were treated with free flaps. No recurrence of bronchopleural fistula was observed during follow-up.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.260-262
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• 2012

Postpneumonectomy empyema is a life-threatening complication, which is often related with a bronchopleural fistula. After surgical repair of fistula, sterilization of infected pleural cavity is important and usually carried out by long-term cyclic irrigation. We report a case in which vacuum-assisted closure device was successfully applied to sterilize the pleural cavity and obliterate bronchopleural fistula.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.792-797
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• 1996

Empyema with bronchopleural fistula is a serious complication after resectional surgery of the lung. Several methods in treating empyema with bronchopleural fistula have been developed, but the results were not always satisfactory. Recently, successful results have been reported with the surgical treatments using tissue flap (the omentum and f or the chest wall muscles) to close the bronchopleural fistula in patients with thoracic empyema. We have performed surgical procedures to treat bronchopleural fistula using omentum in 1 patient an chest wall muscles in 3 patients. Their postoperative courses were uneventful.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.750-757
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• 1990

Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.747-752
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• 1984

Bronchopleural fistula is the communication between a bronchus or bronchiole and the pleural space, clinically bronchopleural fistula is usually combined with infection. But pneumothorax is the communication between a peripheral air space such as a ruptured bleb, and the pleural space. The author studies on the 62 bronchopleural fistula patients who were admitted to P.N.U.H. from 1974 to October, 1984 according to causative mechanism which was postresectional origin, non resectional surgical origin and spontaneous origin, and its underlying diseases. The following results were obtained. 1.The causes of BPF: 5.16% was spontaneous origin, 30.6% was postresectional origin, 17.7% was other surgical origin. 2.The causes of BPF after resectional operation: 42.1% was tuberculosis, 21.1% was tumor resectional case. 3.The proper operational method for BPF was thoracoplasty with myoplasty. 4.The average operation for BPF was 2.7 times.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.648-650
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• 2007

Bronchopleural fistula (BPF) is relatively rare, but it has high morbidity and mortality rates and it is associated with a prolonged hospital stay and high costs. Surgical treatment is the treatment of choice, but other minimal invasive forms of conservative management, and particularly bronchoscopy, have recently been investigated. We report here on the bronchoscopic treatment of a bronchopleural fistula accompanied necrotizing pneumonia, and we used coils and fibrin glue to treat the fistula.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.795-798
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• 2009

Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.72-75
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• 2005

A bronchopleural fistula after pulmonary resection is still showing high mortality and morbidity despite of advancing of treatment. Several treatment options have been developed including surgical treatment. In 1990, endobronchial closure using vascular occluding coils was introduced. These coils can occlude a bronchial air-leakage by mechani­cal obstruction as well as inducing fibrosis. We report, herein, the experience using a vascular occluding coils in treating postoperative bronchopleural fistula.