• Journal of Chest Surgery
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• 제15권3호
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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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• 제23권3호
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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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• 제23권1호
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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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• 제45권4호
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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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• 제29권7호
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• pp.792-797
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• 1996

기관지흥막루를 동반한 농흥은 폐 수술이후 나타날 수 있는 심각한 합병증중의 하나이다. 이같은 기관지 흥막루를 동반한 농흥의 수술을 치료하는 몇가지 방법들이 있으나 그 결과는 언제나 만족스러운 것은 아니다. 최근 조직편 (대망, 흉벽근)을 이용하여 농흥환자에서 기관지흥막루를 막아 좋은 결과를 얻은 보고들이 나오고 있다. 우리는 1명의 환자에서 대망을, 3명의 환자에서 흉벽근을 이용하여 기관지흥막루를 막아주었다. 수술후 환자들은 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제23권4호
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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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• 제17권4호
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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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• 제40권9호
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• pp.648-650
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• 2007

기관지늑막강루는 드문 질환이지만, 일단 생기면 높은 이완율과 치명률을 보이며 입원 기간과 비용부담이 초래되는 합병증의 하나이다. 일반적으로 수술적 치료가 우선이지만, 최근 들어 비침습적 방법으로 기관지 내시경을 이용한 치료가 보고되고 있다. 괴사성 폐렴에 합병된 기관지 늑막강루를 코일과 글루를 사용하여 기관지내시경을 이용, 성공적으로 치료하였기에 그 결과를 보고한다.

• Archives of Plastic Surgery
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• 제36권6호
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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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• 제38권1호
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• pp.72-75
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• 2005

페 절제술 후의 기관지 늑막루는 지금까지 치료법이 발달하였음에도 불구하고 높은 치명률을 보인다. 수술적 치료를 포함하여 많은 치료법이 발전하였는데 1990년 코일을 이용하여 기관지를 막는 방법이 소개되었다. 이 코일은 물리적인 폐쇄와 섬유화를 유발하여 기관지의 공기 누출을 막을 수 있다. 최근 수술 후 발생한 기관지 늑막루에서 코일을 이용한 치료법을 경험하였기에 보고하고자 한다.