Selection of plastic material for covering tracheobronchial anas tomosis

INTRODUCTION. Resections of tracheal bifurcation is a very complex surgery, associated with a very high probability of adverse events in the postoperative period from the tracheobronchial anastomosis.

The OBJECTIVE was to demonstrate the technical aspects of pneumonectomy with resection of tracheal bifurcation, to evaluate various options for covering tracheobronchial anastomosis.

METHODS AND MATERIALS. The cases of 57 patients who underwent resection of tracheal bifurcation were analyzed. In 42 (74 %) cases, such intervention entailed removal of the right lung. In 15 (26 %) cases, left pneumonectomy was performed. All patients were operated on for malignant lung neoplasm.

RESULTS. The effectiveness of using both mediastinal (pericardial flap, adipose flap) and muscular flaps (intercostal muscle, latissimus dorsi muscle), used both to seal the anastomosis and to separate the anastomosis from adjacent vital structures, was revealed. Mediastinal flaps are preferable in terms of minimizing the total time of the operation and reducing trauma to the patient.

CONCLUSION. The use of the presented algorithm for choosing an autoplastic flap allows for the effective use of vari ous options for protecting the bronchial suture line.

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