Tracheal carina reconstruction, fistula repair and esophageal reconstruction assisted by extra-corporeal membrane oxygenation for complex huge tracheoesophageal fistula: a case report.

Abstract

Background: Tracheoesophageal fistula is a pathological communication between the trachea and the adjacent esophagus due to various factors. It is a complicated disease in thoracic surgery, which can seriously affect patients' quality of life and even lead to death. The effect of traditional medical or surgical treatment is not satisfactory, so it is necessary to find a suitable surgical method to improve the prognosis and quality of life of patients.

Case description: A case of benign complex tracheoesophageal fistula is reported. The patient had a history of malignant tumor, which recurred after surgical and medical antitumor therapy. Then esophageal stenosis was caused by radiation esophagitis, and tracheoesophageal fistula was caused after implantation of esophageal stents. After long-term medical and surgical treatments, the patient's condition was still out of well control, complicated with multiple complications, and the quality of life was poor. We completed esophageal stent removal, tracheoesophageal fistula repairing by "double-flaps of esophagus" method, tracheal carina reconstruction, partial esophageal resection, and gastro-esophageal replacement operations in concurrent assisted by extra-corporeal membrane oxygenation (ECMO). Good therapeutic effect was obtained after the surgery.

Conclusions: The "double-flaps of esophagus" method assisted by ECMO can be used as an effective surgical treatment for patients with complex tracheoesophageal fistula, and can significantly improve the prognosis of patients.