Abstract | AIM: The aim of this paper was to verify the effectiveness of omentoplasty, either single or associated to other procedures, in the treatment of permanent fistula of the main bronchi. METHODS: The authors report their experience of 10 intrathoracic omentoplasties for pleural cavity from fistula of the main bronchus. In 2 cases a single omentoplasty was performed, while 8 patients had an associated procedure (4 thoracoplasties, 7 mioplasties and 2 mammoplasties). In 8 cases the vascular pedicle used for the omentum was the right gastroepiploic artery, and the left one in the remaining 2 patients. The omentum was mobilized through an opening in the diaphragm and anchored to the bronchial stump. In the combined plasties it was then covered by chest wall ( thoracoplasty), muscles (mioplasty) or mammary gland ( mammoplasty); in the single omentoplasty omentum was also sutured to the chest wall. Indication for combined procedures was high bacterial contamination of the pleural cavity; single omentoplasty was performed for small cavities, where other procedures had previously failed. Only in the single omentoplasties a pre-operative selective angiography of the gastroepiploic arteries was performed. RESULTS: Such procedures were resolutive in 9 patients; 1 needed an endoscopic application of fibrin glue. CONCLUSION: Intrathoracic omentoplasty is an effective procedure to solve both pleural cavity and stabilized bronchial fistula, mostly because of plastic and immunologic features of the omentum.
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Authors | L Politi, P Scanagatta, A Salani, F Montinaro, A Turini, C Crisci |
Journal | Minerva chirurgica
(Minerva Chir)
Vol. 59
Issue 5
Pg. 495-9
(Oct 2004)
ISSN: 0026-4733 [Print] Italy |
Vernacular Title | L'omentoplastica intratoracica nella cura del cavo pleurico secondario a fistola bronchiale stabilizzata. |
PMID | 15494677
(Publication Type: Evaluation Study, Journal Article)
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Topics |
- Bronchial Fistula
(complications, diagnosis, surgery)
- Bronchoscopy
- Empyema, Pleural
(diagnostic imaging, etiology, surgery)
- Humans
- Omentum
(transplantation)
- Pleural Cavity
- Thoracoplasty
- Tomography, X-Ray Computed
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