1/9. Two cases of benign tracheo-gastric fistula following esophagectomy for cancer.Two successfully managed cases of esophageal replacement for cancer complicated by neoesophagotracheal fistula are described. In both cases radical esophagectomy with a gastric pull-up was performed. In the postoperative period different complications necessitated prolonged ventilatory support and tracheostomy. In both cases a tracheo-gastric fistula developed probably because of the ischaemic effort of the tracheostomy tube and the nasogastric tube. At single stage repairs, the fistulae were divided and the gastric defects were closed directly. In the first case resection of four strictured tracheal rings and tracheal anastomosis had to be performed. In the second case the fistula was recognized earlier and stricture did not develop. The defect on the membranous trachea was patched with autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the trachea and the pulled up stomach in both cases to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.- - - - - - - - - - ranking = 1keywords = muscle, cancer (Clic here for more details about this article) |
2/9. Late esophagopleural fistula after left pneumonectomy: report on one case.Esophagopleural fistula is an uncommon complication of pneumonectomy. Late nonmalignant esophagopleural fistula after left pneumonectomy for lung cancer is exceedingly uncommon. We report on one patient who developed such a fistula 33 months after the operation. signs and symptoms were first attributed to infection of the thoracotomy incision and diagnosis was made only after detection of some food coming from the pleural space. thoracostomy, enteral feeding by a percutaneously placed gastrostomy tube and myoplasty allowed both closure of the fistula and obliteration of the pleural space.- - - - - - - - - - ranking = 0.14347590261673keywords = cancer (Clic here for more details about this article) |
3/9. Video-assisted thoracoscopic treatment for pleuroperitoneal communication in peritoneal dialysis.Massive hydrothorax is an uncommon but well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD). We performed a video-assisted thoracoscopic resection of the pleuro-peritoneal communication and pleurodesis in a patient with massive right hydrothorax secondary to CAPD. Histologically, the resected diaphragm was lacking in common tissue, tendons and skeletal muscle tissues, is displaced to fibrous connective tissue. These anatomic findings suggested that the cause of communication was congenital diaphragmatic change. Video-assisted thoracoscopic treatment facilitated efficient inspection and easy resection of the weak portion of the diaphragma in the case of pleuroperitoneal communication.- - - - - - - - - - ranking = 0.28262048691635keywords = muscle (Clic here for more details about this article) |
4/9. Delayed closure of persistent postpneumonectomy bronchopleural fistula.A 73-year-old man with a history of postpneumonectomy empyema and a long-term chest tube since 1979 presented with fever, chills, leukocytosis, and purulent fluid from the left tube thoracostomy. CT scan and bronchoscopy demonstrated a right lower lobe pneumonia and a left mainstem dehiscence with direct communication to the left tube thoracostomy. He underwent primary closure of the bronchopleural fistula with latissimus dorsi muscle flap coverage after antibiotic therapy for right lower lobe pneumonia.- - - - - - - - - - ranking = 0.28262048691635keywords = muscle (Clic here for more details about this article) |
5/9. Surgical repair for tracheo-innominate artery fistula with a muscle flap.A 70-year-old woman was quickly diagnosed as having tracheo-innominate artery fistula by three-dimensional computed tomography. Immediate surgical exploration was performed to control the bleeding using a temporary shunt. After the damaged artery was excised, vascular reconstruction was performed to preserve the connection between the proximal and distal ends of the innominate artery with the interposition of a saphenous vein graft. A pedicled sternocleidomastoid muscle flap was successfully used for the tracheal reconstruction.- - - - - - - - - - ranking = 1.4131024345818keywords = muscle (Clic here for more details about this article) |
6/9. Transposition of modified latissimus dorsi musculocutaneous flap in the treatment of persistent bronchopleural fistula after posterolateral incision.The condition of a 51-year-old man was complicated with empyema and bronchopleural fistula (BPF) after left upper lobectomy and thoracoplasty for pulmonary aspergillosis. On the postoperative day (POD) 12, the opened bronchial stump was directly closed and covered with a pedicled pectoralis major muscle flap. On POD 66, an open-window thoracostomy was done, because of empyema with pseudomonas aeruginosa Two years later, we could fill the empyema cavity, and close the multiple BPFs with the transposition of a modified pedicled musculocutaneous (MC) flap and the additional thoracoplasty to gain good quality of life. Although the MC flap was a proximal part of the latissimus dorsi muscle, which was dissected along the posterolateral incision of the first operation, it could be successfully transplanted to cover the BPFs in the open-window. In some patients with a small open-window on the upper anterior chest wall, the pedicled proximal latissimus dorsi MC flap may be very useful for treating persistent BPFs even after a standard posterolateral incision.- - - - - - - - - - ranking = 0.56524097383271keywords = muscle (Clic here for more details about this article) |
7/9. Bronchopleural fistula treated with a covered wallstent.Bronchopleural fistula is a well-recognized complication of pneumonectomy, which presents a difficult challenge to the thoracic surgeon. We report the successful treatment of a bronchopleural fistula after right pneumonectomy for lung cancer, using a covered esophageal stent.- - - - - - - - - - ranking = 0.14347590261673keywords = cancer (Clic here for more details about this article) |
8/9. Tracheoinnominate fistula: surgical management of an iatrogenic disaster.Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.- - - - - - - - - - ranking = 0.28262048691635keywords = muscle (Clic here for more details about this article) |
9/9. The use of decellularized dermal grafting (AlloDerm) in persistent oro-nasal fistulas after tertiary cleft palate repair.To assess the efficacy of decellularized dermal grafting as an adjunct to the closure of recurrent oro-nasal fistulas. Five consecutive patients with recurrent oro-nasal fistulas were repaired with decellularized dermal grafting sandwiched between oral and nasal flaps of a von Langenbeck palatal repair. All patients had previously undergone a minimum of three prior palatal repairs with the recurrence of their oro-nasal fistula in the post-alveolar area. Decellularized dermal graft was placed between the nasal mucosa and the levator veli palatine muscle. patients were followed postoperatively and assessed for infection, dehiscence, signs of rejection, and fistula recurrence. All patients were followed for an average of three months. Clinical examination revealed no recurrence of their oro-nasal fistula nor associated symptoms of nasal reflux. Decellularized dermal grafts were not rejected nor extruded from the site of surgical repair. Decellularized dermal graft should be considered for use in the treatment of recurrent oro-nasal fistula after cleft palate repair. We would also like to encourage further clinical study.- - - - - - - - - - ranking = 0.28262048691635keywords = muscle (Clic here for more details about this article) |