Vertical rectus abdominis myocutaneous free flap repair of post-pneumonectomy bronchopleural fistula: a case report.

Autor:	Brennan PG; Department of Surgery, University of California, San Francisco-East Bay, Oakland, CA, USA., Hsu DS; Department of Surgery, University of California, San Francisco-East Bay, Oakland, CA, USA., Banks KC; Department of Surgery, University of California, San Francisco-East Bay, Oakland, CA, USA., Maxim CL; Department of Thoracic Surgery, Kaiser Permanente Northern California, Oakland, CA, USA., Hornik B; Department of Plastic Surgery, Kaiser Permanente Northern California, Oakland, CA, USA., Velotta JB; Department of Thoracic Surgery, Kaiser Permanente Northern California, Oakland, CA, USA.
Jazyk:	angličtina
Zdroj:	AME case reports [AME Case Rep] 2022 Oct 30; Vol. 6, pp. 33. Date of Electronic Publication: 2022 Oct 30 (Print Publication: 2022).
DOI:	10.21037/acr-22-20
Abstrakt:	Background: Bronchopleural fistula (BPF) is a seldom encountered yet serious complication after thoracic surgery, and is often difficult to treat. Large BPFs usually require surgical intervention, and a variety of different surgical reconstruction options have been previously described. This case report presents the first description of a successful vertical rectus abdominis myocutaneous (VRAM) free flap repair of a BPF after pneumonectomy. Case Description: A 46-year-old male with a cough was found to have a right upper lobe lung mass with hilar involvement initially remarkable for epithelioid malignant mesothelioma on biopsy. After neoadjuvant chemotherapy, he underwent right extrapleural pneumonectomy and developed a late right mainstem BPF with associated empyema from adjuvant chemotherapy and COVID-19 pneumonia. He was treated with open Clagett window (OCW) to address the infection and then staged VRAM free flap coverage of the BPF. The patient recovered successfully and has since been able to pursue more demanding activities at home. Conclusions: This case presents the only successful VRAM free flap for a BPF involving the entire right mainstem bronchus at the carina. VRAM free flap repair offers a useful treatment option for BPFs, especially in patients with large pleural cavity defects. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://acr.amegroups.com/article/view/10.21037/acr-22-20/coif). The authors have no conflicts of interest to declare. (2022 AME Case Reports. All rights reserved.)
Databáze:	MEDLINE
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