右肺全摘後断端瘻に大網を気管支内挿入し閉鎖した1例

Successful Closure of Postpneumonectomy Bronchopleural Fistula with Inserting Technique of Omental Pedicle Flap into the Right Main Bronchus：Report of a Case

はじめに　肺癌に対する右肺全摘術後に断端瘻，膿胸を発症し，右主気管支断端が全開状態となった症例に対して，大網による瘻孔閉鎖，広背筋肉弁充塡，胸郭形成術を行ったので報告する．

A 67-year-old male was admitted to our hospital for the treatment of pyothorax due to bronchopleural fistula at right main bronchus after pneumonectomy for lung cancer （squamous cell carcinoma, pathological stageⅢB）. After tube drainage and fenestration, we performed operation to close large diameter fistula, that was almost fully opened stump of the right main bronchus. Omental flap was sutured roughly to the fistula with four stiches and inserted into the bronchus lumen, and covered with latissimus dorsi muscle flap to fix omental pedicle flap and additionally performed thoracoplasty to close the residual space of the pleural cavity. Fistula at the stump became airtight after operation and pyothorax was cured, so our method was thought to be available to close large diameter bronchopleural fistula with omental pedicle flap.