# Long-term retention of the pedicled thymic flap after bronchial stump coverage

## TL;DR

This study shows that pedicled thymic flaps can be safely used to cover bronchial stumps and remain in place for over a year, reducing the risk of serious complications.

## Contribution

The study demonstrates long-term retention rates of pedicled thymic flaps using a minimally invasive technique for bronchial stump coverage.

## Key findings

- 100% retention rate of thymic flaps at 60 days post-surgery.
- 70% retention rate at 1 year post-surgery.
- No complications from graft harvest or fixation using a minimally invasive approach.

## Abstract

This study aimed to assess the feasibility and retention rates of pedicled thymic flaps to enhance understanding of bronchial stump coverage. A retrospective analysis of 22 consecutive patients who underwent anatomical lung resection followed by bronchial stump coverage with pedicled thymic flaps between January 2017 and December 2022 was conducted. The procedure was performed using a minimally invasive three-port video-assisted thoracoscopic surgery technique for all patients with no complications related to graft harvest or fixation. Postoperative retention of the engrafted flaps was evaluated in the 16 patients who underwent thin-slice computed tomography at least once after surgery. The majority of the postoperative computed tomography examinations were performed for surveillance of lung cancer recurrence. The retention rates of pedicled thymic flaps were 100% at 60 days, 87% at 180 days and 70% at 1 year post-surgery. Pedicled thymic flaps can be safely harvested using a minimally invasive approach, and the majority of engrafted flaps remain adjacent to the bronchial stump for more than 1 year. This technique may be a viable option for patients at high risk of a delayed bronchopulmonary fistula.

A bronchopulmonary fistula (BPF) is one of the postoperative complications associated with increased surgical mortality following lung resection.