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Ann Thorac Surg 2005;79:2130-2132
© 2005 The Society of Thoracic Surgeons

Case report

A Novel Procedure Using a Tissue Expander for Management of Persistent Alveolar Fistula After Lobectomy

Yasushi Sakamaki, MDa,*, Tetsuo Kido, MDa, Takashi Fujiwara, MDb, Katsuki Kuwae, MDb, Motomu Maeda, MDb

a Department of Chest Surgery, Osaka Police Hospital, Osaka, Japan
b Department of Plastic Surgery, Osaka Police Hospital, Osaka, Japan

Accepted for publication November 25, 2003.

* Address reprint requests to Dr Sakamaki, Department of Chest Surgery, Osaka Police Hospital, Kitayamacho 10-31, Tennoji, Osaka 543-8502, Japan (E-mail: sak{at}serenade.plala.or.jp).

We treated a patient with postlobectomy persistent alveolar fistula using a tissue expander, which is a prosthesis widely used in plastic surgery. The patient had thoracic empyema develop after right bilobectomy for lung cancer, and consequently underwent drainage of empyema followed by muscle flap closure for alveolar fistula. A residual space remained, and air leak persisted. However, implanting and expanding a tissue expander enabled us to tightly fix the flap on the raw pulmonary surface, which eventually solved the air leak. The tissue expander greatly contributed to muscle flap closure for a persistent alveolar-pleural fistula with a large remaining thoracic space.






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