Video-assisted Abruzzini technique for bronchopleural fistula repair. A pathology study

Trans-sternal closure of the bronchial stump is an effective procedure to treat bronchopleural fistula after pneumonectomy. The paper reports a modified video-assisted Abruzzini technique that, maintaining the same results, should determine a lower surgical risk. Three simultaneous approaches are used: cervical video-mediastinoscopy, right anterior parasternal mediastinotomy, left parasternal thoracoscopic access. The dissection of the bronchial stump is performed entirely through the mediastinotomy approach after having controlled mediastinal vessels. The bronchial stump re-amputation is achieved by a roticulator endoGIA introduced through the cervicotomy either for the right or left fistulae. The technique proposed might reach the same result as the classic approach with lower surgical risks.