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. 2022 Oct-Dec;18(4):638-640.
doi: 10.4103/jmas.jmas_67_22.

Thoracoscopic pericardial patch repair of iatrogenic major bronchial injury during oesophagectomy

Srikanth Gadiyaram  1 , Murugappan Nachiappan  1
Affiliations

Thoracoscopic pericardial patch repair of iatrogenic major bronchial injury during oesophagectomy

Srikanth Gadiyaram et al. J Minim Access Surg. 2022 Oct-Dec.

Abstract

Tracheobronchial injuries are rare but dreaded and potentially lethal complications of oesophagectomy. The reported literature on tracheobronchial injuries in thoraco-laparoscopic oesophagectomy is sparse. They may be detected either intraoperatively or in the post-operative period. Those tracheobronchial injuries detected intraoperatively usually need conversion to an open procedure for appropriate management. The surgical approaches and the methods employed for closure depend on the size and location of the rent. The methods of surgical repair include primary closure, gastric patch closure, pericardial patch, pleural patch, pedicled intercostal muscle flap, dural graft and synthetic polytetrafluoroethylene grafts. Herein, we report a thoracoscopic repair of a major bronchial injury encountered in a patient during thoracoscopic oesophagectomy using a pericardial patch. To the best of our knowledge, this is the first report of a thoracoscopic repair of a bronchial injury using a pericardial patch.

Keywords: Major bronchial injury; pericardia patch; thoracoscopy.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
(a) Rent in the left main-stem bronchus (arrow), close to the carina 'C'. Right main-stem bronchus 'RB' and pericardium 'P' are also seen, (b) Pericardial patch 'PP' taken up to the rent (arrow) exposing the myocardium 'M', (c) sutures taken in the membranous part of the left main-stem bronchus, (d) Pericardial patch repair. 'PP' Pericardial patch, 'M' Myocardium, 'RB' Right main-stem bronchus, 'C' Carina, 'P' Pericardium
Figure 2
Figure 2
(a) Dorsal view of the trachea-bronchial tree in relation to the heart and the great vessels, (b) rent in the left main-stem bronchus close to the carina
Figure 3
Figure 3
(a) Vicryl sutures placed at the defect, (b) superiorly based pericardial flap transposed to the area of the defect, (c) sutures are tied over the pericardial flap closing the defect in the bronchus
See this image and copyright information in PMC

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References

    1. Bartels HE, Stein HJ, Siewert JR. Tracheobronchial lesions following oesophagectomy: Prevalence, predisposing factors and outcome. Br J Surg. 1998;85:403–6. - PubMed
    1. Lui N, Wright C. Intraoperative tracheal injury. Thorac Surg Clin. 2015;25:249–54. - PubMed
    1. Koshenkov VP, Yakoub D, Livingstone AS, Franceschi D. Tracheobronchial injury in the setting of an esophagectomy for cancer: Postoperative discovery a bad omen. J Surg Oncol. 2014;109:804–7. - PubMed
    1. Meyer M. Latrogenic tracheobronchial lesions – A report on 13 cases. Thorac Cardiovasc Surg. 2001;49:115–9. - PubMed
    1. Gorenstein LA, Abel JG, Patterson GA. Pericardial repair of a tracheal laceration during transhiatal esophagectomy. Ann Thorac Surg. 1992;54:784–6. - PubMed