P-233AUTOLOGOUS PERICARDIUM TO RECONSTRUCT TRACHEOBRONCHIAL AIRWAY IN MALIGNANT DISEASES

Abstract

Objectives: We present 2 cases where autologous pericardium was used to reconstruct a large defect of the tracheobronchial tree after surgical resection for tumoural pathology and their posterior evolution. Case description: A 45-year-old female was diagnosed of a 6-cm long squamous oesophageal carcinoma located at 24 cm from the dental arch. Induction chemo-radiotherapy was administered and a 18x80mm long endo-oesophageal stent was deployed due to dysphagia. A transthoracic oesophagectomy was performed. By disection of the oesophagus an oesophagotracheal fistula was discovered. After detatchment of the oesophagus from the trachea a 3x2 cm size defect remained affecting the carina and right main bronchus. The defect was repaired with a free patch of autologous pericardium and covered by a pedicled serratus anterior muscle flap. Postoperative recovery was complicated by a severe bilateral pneumonia. The patient was discharged 92 days later without any complication at the tracheobronchial repair. A 73-year-old man was diagnosed with 2 metastases of large intestine adenocarcinoma, one in the liver and another in the pulmonary right lower lobe (RLL). One month after hepatic surgery he was operated on the right lung. A posterolateral thoracotomy was performed and superior segmentectomy of the RLL extended to a 2x1 cm size patch of the intermediate bronchus. The defect was closed with a free flap of autologous pericardium and covered by a pedicled parietal pleura flap. He was discharged 6 days later without any major complication. Six months after the surgery there was no complication related to bronchial repair. Conclusions: In selected cases, autologous pericardium can be a useful, effective, and easy option to reconstruct the tracheobronchial tree in surgery for tumoural pathology.