ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Transsternal-Transpericardial Closure in the Early and Late Bronchopleural Fistula Following Pneumonectomy
Cengiz GEBİTEKİN, Köksal EKEN, Hayati ÖZKAN, Ziya G. ÖZER, *Ali N. JILAIHAWI
Uludağ Üniversitesi Tıp Fak. GKDC ABD, Bursa,
*Hairmyres Hospital, Regional Thoracic Surgery Unit Glasgow, UK
Bronchopleural fistula (BPF) remains a grave complication of pulmonary resection, particularly following pneumonectomy, that may occur in the early postoperative period or later. Fistalus occuring in the early postoperative period are best treated by immediate reoperation and reclosure of the fistula using various methods. These methods are also used for the chronic fistulas developing in the early or late postoperative period. Three cases with bronc hopleural fistula following pneumonectomy were treated by transpericardial-transsternal (TS-TPK) approach following the Clagett window performed as an initial drainage of the cavity. The operation following the diagnosis of the BPF was performed on the 32th and 37th days in the first two cases and in the 6th year in the third case who had been followed up for chronic empyema and BPF. Clagett window was successfully closed in the first two cases. Both cases are still alive and has no BPF or recurrence of the tumour two and six months after procedure whereas the last developed cardiorespiratory failure and died on the 16th postoperative day. There was no fistula in bronchoscopy and exploration. The technique is relatively simple and safe as well as well tolerated compared to the other closure techniques performed via thoracotomy.
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