Korean J Thorac Cardiovasc Surg.  1998 May;31(5):540-543.

Transsternal Approach for BPF closure: A Case Report

• Jung WS
• Yang SH
• Jeon SH
• Shin SH
• Kim YH
• Suh JK
• Kim GH
• Lee JY

Abstract

A patient with post-pneumonectomy empyema was treated sucessfully by modification of Clagett's operation after closure of bronchopleural fistula using a transsternal, transpericardial approach. His primary disease was pulmonary tuberculosis, and he had a past history of left upper lobe lobectomy 34 year ago. Recently recurred pulmonary tuberculosis with aspergilloma in the remaining left lung, empyema with bronchopleural fistula had developed on the post-operative 4th day after completion pneumonectomy. Closed thoracostomy was done at the lowest point of the left pleural cavity immediately. The pleural cavity was irrigated with small amount of normal saline through pigtail catheter. The 2nd operation was done by closure of bronchopleural fistula using a stapler through transsternal, transpericardial approach, and then the pleural space was irrigated with normal saline with Tobramycin which shows sensitivity to isolated organism from pleural cavity. After negative conversion of pleural fluid culture, we performed modified Clagett's operation under local anesthesia. The patient had no evidence of recurrence of empyema and discharged from hospital after 10 days of the 3rd procedure.

Keyword

Empyema; Postoperative complication; Bronchopleural fistula; Pneumonectomy; Thoracoscopy

MeSH Terms

Anesthesia, Local
Catheters
Empyema
Fistula
Humans
Lung
Pleural Cavity
Pneumonectomy
Postoperative Complications
Recurrence
Thoracoscopy
Thoracostomy
Tobramycin
Tuberculosis, Pulmonary
Tobramycin