The improved method of transsternal omentoplasty of stump of the main bronchus after pneumonectomy

Introduction. One of the principal aspects of successful completion of pneumonectomy (PE) is the technical improvement of methods cover the bronchial stump (BS). Purpose: Prevention of failure of the stump of the main bronchus after PE. Material and Methods: We have developed a method of omentoplasty of BS, which was applied in 31 patients after PE. Transsternal access allows us: - to produce an adequate revision and removal of fatty tissue of anterior mediastinal lymph nodes with others; - to make mobilization of the trachea and the initial portion of the right and the left main bronchus with removing paratracheal lymph node and lymphadenectomy of cervical nodes. It’s enough to use the most vascularized fragment of the greater omentum, with the formation of the vascular pedicle of omentum from the right or from the left gastroepiploic vessels through the transsternal access. This access can not only use the most appropriate in terms of sustainability part of the greater omentum, but also eliminates the need for the mobilization of hepatic ligaments and making the seal when the right-transthoracic access. After the fragment of the greater omentum through the site laparoscopic-sternal fixation period is to seal BS double reciprocal U-shaped suture. Results. Strengthening of the BS by flap of greater omentum on the developed technique is characterized by high efficiency reaches 93.8%. Conclusions: The use of transsternal omentoplasty after PE on the developed methodology significantly reduces the percentage of failure with the formation of the BS fistula and septic complications after PE. At the same time, postoperative mortality decreased by 2.1 times, which is 6.5%.