Use of the posterior pericardium to cover the bronchial stump after right extrapleural pneumonectomy.

Limited tissue is available to cover the bronchial stump after right extrapleural pneumonectomy for malignant pleural mesothelioma. After completing the resection, the pericardial reflection can be freed from the superior vena cava, the right pulmonary artery and veins, and the posterior wall of the pericardial sac between the transverse and oblique pericardial sinuses. The length and mobility from the posterior pericardium can then provide excellent coverage for the right bronchial stump. This technique has the advantage of being easy to perform and requiring limited time and dissection.