Extracorporeal lung support for tracheoesophageal fistula surgical repair with free flap. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Bauer, C.; Jacquenod, P.; Fuchsmann, C.; Philouze, P.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 51:Issue 7(2022)
• Page Start: 883
• Page End: 885
• Publication Date: 2022-07
• Subjects: extracorporeal membrane oxygenation -- free flap -- tracheoesophageal fistula -- trachea; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2021.11.011
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Tracheoesophageal fistula results in persistent leakage of saliva into the trachea, prevents oral feeding, and predisposes to aspiration pneumonia. Large fistula closure may require a free flap to cover the defect. When the defect involves the tracheal area between the neck and the mediastinum, a tubeless field for optimal exposure can be advantageous. This article reports the use of veno-venous extracorporeal lung support, a known safe and efficient technique to support the patient's respiratory function, for this purpose. The typical veno-venous extracorporeal lung support setting includes a femoro-jugular bypass. The patient cases reported here had characteristics that precluded the use of the jugular vein, such as neck radiation dermatitis, previous radical neck dissection, and poor accessibility. Therefore a more rarely described femoro-femoral approach was used. The cases of three patients with persistent tracheoesophageal fistula who had free flap surgeries (two bi-paddled radial forearm free flap and one latissimus dorsi muscle free flap) assisted by femoro-femoral veno-venous extracorporeal lung support are reported.