Successful closure of bronchopleural fistula by omental pedicle flap in patients with tuberculosis and chronic empyema

概要

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Bronchopleural fistulae were successfully closed by omental pedicle flaps in six patients with tuberculosis and chronic empyema. Two had tuberculous empyema and four had chronic empyema as sequelae of pulmonary tuberculosis. A pedicle of omentum containing the right epigastric artery was passed through an opening in the anterior diaphragm into the empyema cavity. It was fixed by sutures to the bronchopleural fistulae and filled in the interstices of the empyema cavity. Two patients underwent postmortem evaluation after dying from respiratory failure 7 and 15 months postoperatively. There was no necrosis or infection in the pedicled omentum. Histologic examination revealed ciliated epithelium of the inner wall of the omentum in the bronchopleural fistula. We believe the omental pedicle flap is a promising method of treating long-standing bronchopleural fistula, i.e. tuberculosis-related chronic empyema.
特定非営利活動法人日本呼吸器外科学会の論文