Preoperative flexible bronchoscopy-aided cannulation of a neonatal H-type tracheo-oesophageal fistula assists intraoperative identification of the fistulous tract

Procopiuc, Livia; Naqvi, Shehryer; Yardley, Iain; Nyman, Andrew G.

doi:10.1186/s43159-022-00207-x

Preoperative flexible bronchoscopy-aided cannulation of a neonatal H-type tracheo-oesophageal fistula assists intraoperative identification of the fistulous tract

Authors

Abstract

Background
The surgical repair of H-type tracheo-oesophageal fistulas situated below the level of the second thoracic vertebra requires an open thoracotomy or a thoracoscopy. We describe a novel technique that allows for the use of a cervical incision to repair a fistula situated in the thorax, thus diminishing surgical risk.
Case presentation
In this report, we describe a 3-day-old term baby with an H-type tracheo-oesophageal fistula where flexible bronchoscopy and gastroscopy were used to cannulate the fistula with a soft ureteric catheter. This allowed for it to be tractioned into the cervical region where it was surgically dissected and isolated. There was no need for re-intervention in the first 3 months after surgery.
Conclusion
Flexible bronchoscopy-aided cannulation of H-type fistulas can assist in intraoperative identification of the fistulous tract as well as help traction it into a surgically more accessible area like the cervical region.

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