A new method for detection of post-pneumonectomy broncho-pleural fistulas

Broncho-pleural fistula is a relatively rare but life-threatening complication of pneumonectomy. Early detection of this complication is crucial for optimal treatment. We describe a simple technique to detect postpneumonectomy broncho-pleural fistula by measuring concentrations of O-2 and N2O in the pneumonectomy cavity at baseline and after allowing patients to breath gas mixtures enriched with O-2, N2O, or both. The technique was used in 22 patients. In 20 control patients the test was carried out 48 hours after pneumonectomy. Both the O-2 and the N2O test were negative in all cases. However, in 2 patients with broncho-pleural fistula both the O-2 and the N2O tests were positive. (C) 2003 by The Society of Thoracic Surgeons.