Article 6121

Title of the article

Omentoplasty of bronchial fistula and residual cavity in patients after pneumonectomy 

Authors

Stanislav I. Stolyarov, Assistant of the sub-department of surgical disease, Chuvash State University named after I. N. Ulyanov (45 Moskovsky avenue, Cheboksary, Russia); thoracic surgeon, deputy chief physician for surgical care, Republican Clinical Hospital (9 Moskovsky avenue, Cheboksary, Russia), E-mail: rkb0342@rkb21.ru
Aleksandr N. Belyaev, Doctor of medical sciences, professor, head of the sub-department of general surgery named after professor N. I. Atyasov, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: belyaevan@mail.ru
Gerasim N. Krasnov, Candidate of medical sciences, associate professor of the sub-department of general surgery and oncology, Chuvash State University named after I. N. Ulyanov (45 Moskovsky avenue, Cheboksary, Russia); surgeon, Republican Clinical Hospital (9 Moskovsky avenue, Cheboksary, Russia), E-mail: gera_krasnov@mail.ru
Nikolay A. Mizurov, Candidate of medical sciences, associate professor of the sub-department of surgical disease, Chuvash State University named after I. N. Ulyanov (45 Moskovsky avenue, Cheboksary, Russia), E-mail: nik.mizurov@mail.ru 

Index UDK

61.617-089 

DOI

10.21685/2072-3032-2021-1-6 

Abstract

Background. Failure of the bronchus stump after pneumonectomy is one of the most severe complications after lung surgery, while the incidence of bronchopleural fistulas remains high.
Materials and methods. The results of pneumonectomy in 99 patients for various lung diseases are presented. In the postoperative period, 9 patients developed bronchial stump failure, and primary failure was detected in 3 patients, secondary – in 6 patients. With the primary failure of the bronchial stump of small size, conservative therapy was carried out, and with the secondary one, a repeated operation aimed at eliminating the bronchial fistula was carried out. 3 patients underwent omentoplasty of the bronchial fistula of the right main bronchus stump, in 1 patient – using the laparoscopic approach, all had a favorable result.
Results and conclusions. One of the clinical observations is presented. Omentoplasty of a bronchial fistula can be successfully used in the development of secondary incompetence of the main bronchus stump after pneumonectomy. 

Key words

pneumectomy, bronchial fistula, omentoplasty 

Download PDF
References

1. Chichevatov D.A., Gorshenev A.N., Sinev E.N., Sergeev I.V. Contemporary statistics of postoperative bronchopleural fistulas. Kazanskiy meditsinskiy zhurnal = Kazan medical journal. 2005;6:491–493. (In Russ.)
2. Gursov S., Yapucu M.U., Ucvet A. [et al.]. Fidrin glue administration to support bronchial stump line. Ann. Thorac. Surg. 2008;16(6):450–453.
3. Uramoto H., Hanagiri T. The development of bronchopleural fistula in lung cancer patients after major surgery: 31 years of experience with 19 cases. Anticancer Res. 2011;31:619–24.
4. Chichevatov D.A. Profilaktika i lechenie nesostoyatel'nosti kul'ti glavnogo bronkha i trakheobronkhial'nogo anastomoza s primeneniem modifitsirovannykh variantov omentoplastiki: avtoref. dis. kand. med. nauk = Prevention and treatment of incompetence of the stump of the main bronchus and tracheo-bronchial anastomosis using modified variants of omentoplasty: author’s abstract of dissertation to apply for the degree of the candidate of medical sciences. Saransk, 2002:17. (In Russ.)
5. Lishenko V.V. Prevention and treatment of bronchial stump failure and bronchial fistulas after pneumonectomy. Materialy I Mezhdunar. konf. po torako-abdominal'noy khirurgii = Proceedings of the 1st International conference on thoraco-abdominal surgery. Moscow, 2008:292. (In Russ.)
6. Grigor'ev E.G., Kaporskiy V.I., Ayushinova N.I. [et al.]. Intraluminal omentobronchoplasty and myothoracoplasty after pneumonectomy for common gangrene of the lung. Grudnaya i serdechno.-sosudistaya khirurgiya = Breast and cardiovascular surgery. 2006;3:65–67. (In Russ.)
7. Nazyrov F.G., Khudaybergenov Sh.N. [et al.]. Improved method of plasty of the main bronchus stump after pneumonectomy. Khirurgiya = Surgery. 2010;5:53–55. (In Russ.)
8. Nakajima Y., Akiyama H., Kinoshita H., Inoue T., Hamahata A., Uramoto H. Two cases of single-stage closure of a bronchopleural fistula using latissimus dorsi musculocutaneous flaps after lung surgery. Ann Thorac Cardiovasc Surg. 2015;21:496–499.
9. Schneiter D., Grodzki T., Lardinois D., Kestenholz P.., Wojcik J., Kubisa B. [et al.]. Accelerated treatment of postpneumonectomy empyema: a binational long-term study. J Thorac Cardiovasc Surg. 2008;136:179–85.
10. Jiang F., Huang J., You Q. [et al.]. Surgical treatment for bronchopleural fistula with omentum covering after pulmonary resection for non-small cell lung cancer. Thorac Cancer. 2013;4:249–53.
11. Goussard P., Kling S. [et al.]. Fibrin glue closure of persistent bronchopleural fistula fol-lowing pneumonectomy for post-tuberculosis bronchiectasis. Pediatr. Pulmonol. 2008;43(7):721–725.
12. Krasnov G.N. Ul'trazvukovye aerozol'nye ingalyatsii sul'fata tsinka v profilaktike nesostoyatel'nosti kul'ti bronkha pri gnoyno-destruktivnykh zabolevaniyakh legkikh: avtoref. dis. kand. med. nauk = Ultrasonic aerosol inhalation of zinc sulfate in the prevention of bronchial stump failure in purulent-destructive lung diseases: author’s abstract of dissertation to apply for the degree of the candidate of medical sciences. Saransk, 2010:17. (In Russ.)
13. Sarkar P., Chandak T., Shah R., Talwar A. Diagnosis and management bronchopleural fistula. Indian J Chest Dis Allied Sci. 2010;52:97–104.
14. Weerd de L., Endresen P.C., Numan A.T., Weum S. Intrathoracic Breast Transposition: A New Method in the Treatment of Bronchopleural Fistula and Empyema. Plast Reconstr Surg Glob Open. 2019;7:2531. doi:10.1097/GOX.0000000000002531
15. D'Andrilli A., Ibrahim M., Andreetti C. [et al.]. Transdiaphragmatic harvesting of the omentum through thoracotomy for bronchial stump reinforcement. Ann Thorac Surg. 2009;88:212–5.

 

Дата создания: 17.05.2021 10:39
Дата обновления: 17.05.2021 13:15