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

Abstract

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.

Keywords

• Bronchoscopy
• Tracheo-oesophageal fistula
• Neonatal surgery
• H-type fistula