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Ann Thorac Surg 1989;47:231-235
© 1989 The Society of Thoracic Surgeons

Articles

Closure of chronic postpneumonectomy bronchopleural fistula using the transsternal transpericardial approach

Robert J. Ginsberg, MD*,a,b, F.Griffith Pearson, MDa,b, Joel D. Cooper, MDa,b, Ernest Spratt, MDa,b, Jean Deslauriers, MDa,b, Melvyn Goldberg, MDa,b, Robert D. Henderson, MDa,b, Donald Jones, MDa,b

a Divisions of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada
b Hopital Laval, Sainte-Foy, Quebec, Canada

* Address reprint requests to Dr Ginsberg, Mount Sinzi Hospital, 600 University Ave, Suite 451, Toronto, Ont, Canada M5G 1X5.

Thirteen patients with postpneumonectomy bronchopleural fistula occurring 4 months to 10 years after the initial operation have been treated with a transsternal transpericardial approach after the associated empyema had been treated by either tube thoracostomy or openwindow thoracostomy. In 10 patients, there were contraindications to using an ipsilateral transthoracic approach. In 10 of the 13 patients, the procedure was successful. Three fistulas recurred; two were quite small, one of them closing spontaneously within 6 months. There were no deaths or clinically significant morbidity related to the transsternal approach. We have found this technique to be most applicable in those patients in whom other procedures have failed to resolve the problem. The technique is relatively simple and safe.




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