PROTECTION AND REVASCULARIZATION OF BRONCHIAL ANASTOMOSES BY THE INTERCOSTAL PEDICLE FLAP

We used an improved method for preparation of the intercostal pedicle flap for encircling bronchial anastomoses, and we studied its vascular supply after the operation. The flap was used in 56 patients undergoi ng various types of sleeve resection and in three patients undergoing single lung transplantation. The technique is simple, fast, and causes neither extra surgical trauma nor complications. It allows satisfacto ry isolation and sealing of the bronchial anastomosis. Even if complet e anastomotic dehiscence occurs (one case), the flap preserves the con tinuity of the airway, thus avoiding bronchopleural fistulas or other complications. The postoperative arteriographic study of the intercost al artery supplying the flap (performed in 14 patients) demonstrated t he full patency of the vessel in all cases. It also showed that a fine vascular network develops around the anastomosis early in the postope rative period.