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
