Bronchial stump reinforcement with the intercostal muscle flap without adverse effects

Maniwa, Tomohiro; Saito, Yukihito; Kaneda, Hidehiro; Imamura, Hiroji

doi:10.1016/j.ejcts.2006.07.023

Cited by 24 publications

(16 citation statements)

References 17 publications

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“…Reinforcement of the bronchial stump with viable tissue has been advocated as a prophylactic measure [19]. However, data comparing the outcome of surgery with and without reinforcement of the bronchial stump are not available.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of 26 Patients with Necrotizing Pneumonia

Tsai¹,

Tsai²,

2011

Eur Surg Res

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Background: This study aimed to review the outcome of patients treated with surgical resection for necrotizing lung infection with various co-morbidities and complications. Methods: The records of 26 patients treated with pulmonary resection for necrotizing pneumonia between July 2004 and January 2010 were retrospectively reviewed. Surgical procedures included large wedge resection (n = 1), lobectomy (n = 19) and bilobectomy (n = 6). Results: The study cohort consisted of 21 men and 5 women aged 35–85 years (mean 64.7 ± 15.0 years). Twenty-three (88.5%) patients had underlying risk factors. At surgical consultation, 17 patients presented with progressive respiratory distress; 6 required ventilatory support; 12 had empyema, and in 5 patients the conditions were complicated by bronchopleural fistula. Four patients had septic shock requiring vasopressor support. Three patients developed hemoptysis. Two patients had bilateral diffuse pneumonia. Klebsiella pneumoniaeand Streptococcusviridans were the most common pathogens. The right lower (n = 13) and right middle lobes (n = 10) were the most frequently affected. Four deaths (15.4%) occurred: 3 due to perioperative progressing pulmonary infection/inflammation and 1 due to hepatorenal failure. Postoperative empyema occurred in 3 patients. One patient became ventilator dependent. Conclusion: Pulmonaryresection for necrotizing pneumonia is a feasible treatment option in patients with progressive pulmonary sepsis.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of 26 Patients with Necrotizing Pneumonia

Tsai¹,

Tsai²,

2011

Eur Surg Res

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“…In another larger series, some ossification of pedicles was shown but no clinical sequelae [7]. Longterm follow-up has shown no increased risk of development of bronchopleural fistula [8]. If, as in this case, the ICM flap is applied loosely and used to buttress a tear without circumferential application, then even with some retraction, there is no reason for future stenosis to cause clinical harm.…”

Section: Discussionmentioning

confidence: 94%

Bucket-handle repair of a tear in the bronchus intermedius with an intercostal muscle flap

Booth¹,

Muir²,

Parissis³

2011

European Journal of Cardio-Thoracic Surgery

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As previously well described in the literature, the intercostal muscle (ICM) flap can be used to buttress bronchial stumps following lung resection. We describe a harvesting technique of ICM flap which enabled a bi-lobectomy to be avoided in a patient with poor pulmonary function. The Key to this technique is the preservation of the neurovascular bundle. Therefore the flap is not divided anteriorly thereby differentiating it from any previous technique described.We have called it the 'bucket handle' technique, which was used to repair an intra-operative tear in bronchus intermedius. Its efficacy was tested to the full when the patient developed severe adult respiratory distress syndrome (ARDS) secondary to pseudomonas pneumonia and required high-pressure mechanical ventilation. This case demonstrates that ICM flap is an effective buttress to bronchial stumps or repairs and offers reassurance for optimal outcome due to its intact vascular pedicle.

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“…Pleural flap is quite thin, and it has poor blood supply. It is usually used only to prevent the incidence of fistula during pneumonectomy [24,25]. The use of greater omental flaps has proved to be effective in the management of several complex thoracic surgical problems [26].…”

Section: Discussionmentioning

confidence: 99%

Pericardial Flap: An Effective Method of Surgical Repair of Late Post-Pneumonectomy Fistula

JabłońskiSławomir

BrockiMarian²,

WawrzyckiMarcin³

et al. 2014

Surgical Infections

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Bronchial stump reinforcement with the intercostal muscle flap without adverse effects

Abstract: Bronchial stump reinforcement with the intercostal muscle flap after pulmonary resection is safe and effective when performed during lower and lower-middle lobectomy and does not increase the risk of complications.

Cited by 24 publications

References 17 publications

Surgical Treatment of 26 Patients with Necrotizing Pneumonia

Surgical Treatment of 26 Patients with Necrotizing Pneumonia

Bucket-handle repair of a tear in the bronchus intermedius with an intercostal muscle flap

Pericardial Flap: An Effective Method of Surgical Repair of Late Post-Pneumonectomy Fistula

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