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How-to-do-it

Pericardial flap for bronchial stump coverage after extrapleural pneumonectomy; is it feasible?

Division of Thoracic surgery, Department of Cardiothoracic and Vascular Sciences, University of Padua, Via Giustiniani, 2, 35128 Padova, Italy

Received 28 June 2008; received in revised form 2 September 2008; accepted 8 September 2008.

^_* Corresponding author. Tel.: +39 0498212237; fax: +39 0498212249. (Email: federico.rea{at}unipd.it).

Bronchial stump reinforcement with viable tissue after pneumonectomy is an important prophylactic measure against the development of bronchopleural fistula. We present our technique of utilizing the pericardium on the posterior wall of the left atrium as a flap to cover the bronchial stump after extrapleural pneumonectomy. From January 1999 to March 2008, we used this technique in 50 patients (29 on the right side and 21 on the left side) with no incidence of bronchopleural fistula or empyema. This technique is proved to be feasible, safe and effective; also it does not increase operative time or surgical trauma.

Key Words: Extrapleural pneumonectomy • Complications • Bronchopleural fistula • Pericardial flap