Bronchopleural Fistula After Pneumonectomy: Risk Factors and Management, Focusing on Open-Window Thoracostomy Antonio Mazzella, MD, Alessandro Pardolesi,

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Bronchopleural Fistula After Pneumonectomy: Risk Factors and Management, Focusing on Open-Window Thoracostomy Antonio Mazzella, MD, Alessandro Pardolesi, MD, Patrick Maisonneuve, Francesco Petrella, MD, PhD, Domenico Galetta, MD, Roberto Gasparri, MD, Lorenzo Spaggiari, MD PhD Seminars in Thoracic and Cardiovascular Surgery Volume 30, Issue 1, Pages 104-113 (March 2018) DOI: 10.1053/j.semtcvs.2017.10.003 Copyright © 2017 Elsevier Inc. Terms and Conditions

Figure 1 Direct surgical repair of bronchial stump. Several separated threads were run through its wall. To avoid bronchial wall laceration, 2 absorbable PDS bands were used.11 Seminars in Thoracic and Cardiovascular Surgery 2018 30, 104-113DOI: (10.1053/j.semtcvs.2017.10.003) Copyright © 2017 Elsevier Inc. Terms and Conditions

Figure 2 Management of post-pneumonectomy BPF: IEO algorithm. Seminars in Thoracic and Cardiovascular Surgery 2018 30, 104-113DOI: (10.1053/j.semtcvs.2017.10.003) Copyright © 2017 Elsevier Inc. Terms and Conditions

Figure 3 (A) Right open-window thoracostomy. (B) Packing by 0.5% povidone-iodine and normal saline-filled compresses. (C) CT scan showing right OWT and packing. (D) Closed OWT by myoplasty 14 months after first surgery. (E) OWT: H-shaped incision straddling the second and third ribs. (Color version of figure is available online.) Seminars in Thoracic and Cardiovascular Surgery 2018 30, 104-113DOI: (10.1053/j.semtcvs.2017.10.003) Copyright © 2017 Elsevier Inc. Terms and Conditions

Figure 4 Cumulative incidence of fistula after pneumonectomy and overall survival of patients after onset of pulmonary fistula. (Color version of figure is available online.) Seminars in Thoracic and Cardiovascular Surgery 2018 30, 104-113DOI: (10.1053/j.semtcvs.2017.10.003) Copyright © 2017 Elsevier Inc. Terms and Conditions

OWT: H-shaped incision straddling the second and third ribs. Seminars in Thoracic and Cardiovascular Surgery 2018 30, 104-113DOI: (10.1053/j.semtcvs.2017.10.003) Copyright © 2017 Elsevier Inc. Terms and Conditions