Bronchopleural Fistula Repair

Regardless of the cause of bronchopleural palsy, a closed drainage of the pleural cavity should be performed first to control the infection, and the general condition should be improved, followed by a fistula repair or a pneumonectomy. Treatment of diseases: tuberculous empyema Indication Bronchial pleural palsy. Contraindications Patients with infections in the pleural cavity should be treated with anti-infectives. Preoperative preparation 1. Keep the chest drainage tube unobstructed, so that the abscess does not accumulate, the patient does not have fever; at the same time, the nutritional status should be corrected in time, and fresh whole blood or albumin can be transferred several times if necessary. 2. Because of tuberculosis, preoperative application of effective anti-tuberculosis drugs for at least 1 month; contralateral pulmonary tuberculosis should be basically stable; ESR is close to normal. Antibiotics were added 1 week before surgery. Surgical procedure (1) Bronchial pleural hernia repair after right pneumonectomy 1. Incision: right chest posterolateral incision. 2. After the chest, suck out the pus, scrape the cellulose and granulation tissue, and remove the ribs from the upper and lower and left and right areas of the abscess (see "pleatomy in the pleura"). 3. Ligation, cutting the atypical vein arch, dissection and revealing the bronchospasm. 4. After trimming the bronchial stump, suture the suture with a thin wire and suture the bronchial stump with a ribbed intercostal muscle flap. 5. A closed drainage tube is placed in the thoracic cavity, and a porous drainage tube is placed in the incision. 6. Close the chest layer by layer, drain the water to seal the bottle. (B) bronchial pleural hernia repair after left pneumonectomy 1. The surgical procedure is basically the same as above. 2. Reveal the left bronchus. Take care to avoid damage to the left pulmonary artery and the left superior lung vein. 3. After trimming the bronchial stump, suture the suture with a thin wire and suture the bronchial stump with a ribbed intercostal muscle flap. complication 1. The drainage tube is connected to the double bottle for 4 to 7 days of vacuum suction. 2. Apply antibiotics to control infection. 3. Tuberculosis patients use anti-tuberculosis drugs for 3 to 6 months. 4. Continue to strengthen nutrition support treatment. Postoperative diet 1. Give high protein, high vitamin and cellulose-rich digestible diet. 2, do not eat spicy spicy food. 3, avoid drinking alcohol.