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Eur J Cardiothorac Surg 2006;30:943-944
© 2006 Elsevier Science NL

How-to-do-it

Pleural flap to prevent lobar torsion: a novel technique

Department of Thoracic Surgery, Sureyyapasa Chest and Cardiovascular Diseases Teaching and Research Hospital, Istanbul, Turkey

Received 28 June 2006; received in revised form 4 September 2006; accepted 18 September 2006.

^_* Corresponding author. Address: Hakki Yeten Cad. 17/12, ili 80200, Istanbul, Turkey. Tel.: +90 212 296 1680; fax: +90 212 247 4122. (Email: cakutlu{at}tnn.net).

Lobar torsion is reported as very rare but sometimes catastrophic complication if overlooked during the early postoperative period following a lobectomy, though it is totally preventable. In this novel technique, a piece of parietal pleural flap is harvested from the posterior wall of the chest using a hook diathermy while keeping its upper border as close to the apex as possible. Finally, distal end of the flap is secured to the upper edge of the lobe using a fine monofilament absorbable suture. This procedure not only protects the lobe from rotation but also maintains continuous expansion of the lung in the early postoperative period and may, therefore, be a good option to prevent such a serious complication in selected patients following a lobectomy.

Key Words: Lobectomy • Lobar torsion • Patient safety • Perioperative care • Postoperative complications