Carinal Sleeve Resection for Persistent Bronchopleural Fistula After Completion Right Pneumonectomy

Sleeve bronchoplasty is an uncommon surgical option for the management of bronchopleural fistulae. We present the management of an individual who developed T1N0M0 non-small cell lung cancer involving the right upper lobe 20 years after right lower lobe cancer. Following completion right pneumonectomy, this patient developed a bronchial stump leak. Primary repair of the stump was performed, but failed leading to empyema and necessitated creation of a Clagett window. The size of the stump defect became sufficiently large to render the patient dyspneic and aphonic. A carinal sleeve resection was successful in managing the massive bronchopleural fistula. (Ann Thorac Surg 2010; 89: 1266-8) (C) 2010 by The Society of Thoracic Surgeons