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Thorac Cardiovasc Surg 2010; 58(3): 169-174
DOI: 10.1055/s-0029-1240780
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

A New Treatment Concept for Bronchial Stump Insufficiency

G. Bischoff1 , B. Muehling1 , K. Orend1 , M. Bischoff2 , L. Sunder-Plassmann1
  • 1Department of Thoracic and Vascular Surgery, University Ulm, Ulm, Germany
  • 2Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Ulm, Ulm, Germany
Further Information

Publication History

received April 24, 2009

Publication Date:
07 April 2010 (online)

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Abstract

Introduction: Bronchial stump insufficiency (BSI) remains one of the most feared complications with an incidence of 0–12 % in the literature. Patients and Method: The present retrospective study reviewed the medical records of 11 patients with BSI. Patients were divided into two groups, depending on treatment. In group A, 5 patients were treated initially unsuccessfully using other therapeutic procedures such pectoralis flap transposition, omentum majus transposition and fibrin glue applications and subsequently treated successfully with vacuum therapy (VT). In 6 patients (group B), only VT (a combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT) was performed. VT represents a closed dressing system allowing moist wound treatment in full contact with the wound surface as well as protection against contamination with nosocomial pathogens by means of continuous drainage of wound secretions.

Results: Of the 11 patients reviewed in this study, closure of the bronchial stump with VT was achieved in 8 patients. Of the 8 patients with successful closure of the bronchial stump, 4 patients were in group A and 4 in group B. Conclusion: Based on this preliminary experience, the combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT appears to be a promising concept for the management of bronchial stump insufficiency.

Key words

vacuum therapy - bronchial stump insufficiency - bronchopulmonary fistula

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Dr. Gisela Bischoff, MD

Department of Thoracic and Vascular Surgery
University Ulm
Steinhövelstr. 9

89075 Ulm

Germany

Phone: + 49 (0) 7 31 50 05 40 15

Fax: + 49 (0) 73 15 00 54 03

Email: gisela.bischoff@uniklinik-ulm.de