Extended or combined pneumonectomies were performed in 56 cases of advanced complicated non-small cell lung cancer. Bronchial stump was closed by a modification of Overholt's technique using a vascularised tissue flap. Postoperative complication rate was 66%, mortality--23% and bronchial fistula--1.8% (1 case). Our modification of Overholt's technique using a well vascularised flap from the pericardium, muscle or omentum effectively prevented bronchial fistula in cases of multiple risk and is indicated in all cases of surgery for advanced lung cancer.

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