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Tracheoesophageal fistula repair with veno-venous extracorporeal support and Montgomery T-tube: a case report

Year: 2025

Type: article

Abstract: Tracheoesophageal fistulas (TEFs) are a major surgical challenge requiring a meticulous approach. This case report describes the successful surgical treatment of a 50 mm TEF extending from the upper third of the trachea to 40 mm above the main carina in a young female patient. The chosen strategy involved an extensive transcervical approach, utilization of Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO), and placement of a Montgomery T-tube. The use of ECMO allowed surgical manipulation of mediastinal structures in apnea, ensured adequate gas exchange in the absence of mechanical ventilation, and enhanced comfort during postoperative splinting of the involved structures. The integration of the Montgomery T-tube provided stable airway management postoperatively, particularly advantageous in the context of impaired neurological status precluding early extubation. This combined surgical approach, involving VV-ECMO and Montgomery T-tube, offers a novel, safe, and effective alternative for managing complex TEFs and is recommended for consideration in similar challenging clinical scenarios.

Source: Journal of ExtraCorporeal Technology

DOI: 10.1051/ject/2025055

Authors: José Luis Che Morales, Gary Kosai Vargas Mendoza

Institution: Medical Center of the Americas Foundation

Language: English

Topic: Esophageal and GI Pathology

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,300