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Ann Thorac Surg 2008;85:2112-2114. doi:10.1016/j.athoracsur.2007.11.062
© 2008 The Society of Thoracic Surgeons
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Giuseppe Marulli
Federico Rea
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Case Reports

A Completion Sleeve Bilobectomy for Nonstump Postlobectomy Bronchopleural Fistula

Abdel-Mohsen Hamad, MD, Giuseppe Marulli, MD, Marco Schiavon, MD, Federico Rea, MD*

Division of Thoracic Surgery, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padova, Italy

Accepted for publication November 26, 2007.

* Address correspondence to Dr Rea, Division of Thoracic Surgery, University of Padua, Via Giustiniani 2, Padova, 35128, Italy (Email: federico.rea{at}unipd.it).

We present a novel approach for treatment of nonstump postlobectomy bronchial fistula. Our patient had right lower lobectomy for T3 N2 M0 adenocarcinoma. An increased air leak developed 8 days later, and bronchoscopy revealed the presence of a bronchial fistula. On reexploration, the bronchial stump was intact, and the membranous part of the bronchus intermedius was sloughed up to the opening of the upper lobe bronchus. A middle lobectomy with sleeve resection of the bronchus intermedius and part of the right main bronchus was performed, and the upper lobe was reanastomosed to the right main bronchus. The patient's postoperative course was uneventful, and follow-up bronchoscopy showed an intact healed anastomosis.






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