Novel method for bronchial stump coverage for prevents postpneumonectomy bronchopleural fistula: pedicled thymopericardial fat flap, Retrospective analyzes of 98 patients

Introduction: To prevent postpneumonectomy BPF it was suggested to coverage the bronchial stump in patients with risk factors. For this purpose, usage of omentum, pericardium, pericardial fat pad, thymus, diaphragm, intercostal muscle and pleura as an autologous tissue were described in the literature but there is no consensus on which technique is more successful in preventing BPF development. The aim of this retrospective study is to evaluate the efficacy of bronchial stump coverage with pedicled thymopericardial fat flap in patients who underwent pneumonectomy. Aims and Objectives: We investigated all 98 patients retrospectively and they were divided into two groups: those who underwent pneumonectomy plus bronchial stump coverage with thymopericardial fat flap (Group 1, n = 39) and those who underwent pneumonectomy without bronchial coverage (Group 2, n = 59). We aim to compare intraoperative and perioperative results of these two groups and demonstrate the efficacy and the usefulness of the thymopericardial fat pad flap in patients with pneumonectomy. Results: Bronchial fistula occurred in 1 patient (%2.6) in group 1 and 9 patients (%15.3) in group 2 and these differences was statistically significant (p=0.042). Neoadjuvant radiotherapy rates and mean preoperative albumin levels were also statistically different in these two group (p=0.001 and p=0.051) Conclusions: Bronchial stump reinforcement with a thymopericardial fat flap is a highly effective method for preventing postpneumonectomy bronchopleural fistula in patients with pneumonectomy.