Omentum Transposition as a Solution for Bronchopleural Fistula and Empyema

Bronchopleural fistula (BPF) is still a detrimental problem for thoracic surgeons that cause undesirable results in patients. The aim of this study is to evaluate the results of omentum transposition into the thoracic cavity which is used to treat the patients with BPF and empyema Between April 2008 and May 2018, 29 patients with postoperative BPF, two patients with empyema and one patient with tracheal rupture were treated by omentum transposition into the thoracic cavity to reinforce the bronchial stump and to obliterate the pleural space. Each procedure was performed using both thoracotomy and laparotomy, and the omentum was mobilized to the thoracic cavity by a transabdominal approach. The data of the patients' were analyzed retrospectively. Total length of hospital stay was statistically higher in females (59 days) compared with males (38 days) (p = 0.04) and statistically lower in patients with lung cancer (34 days) compared with patients with benign diseases (57 days) (p = 0.016). There was a positive correlation between the age of patients, chest tube removal time, and the duration of hospital stay after omentopexy (r = 0.53, p = 0.002, r = 0.53, p = 0.01, respectively). The success rate was found to be 72% (n = 23) in the patients who underwent primary repair with omentopexy. Only 5 patients were discharged with a Heimlich valve. There was no complication associated with the omentum transposition except minimal temporary dyspeptic symptoms. Omentum transposition seems to be an invasive intervention for these patients. However, this research's results reveal that BPF and empyema can be treated safely by omentum transposition.