case_images: PMC9679631_01
case_images: Characteristics of the thoracogastric airway fistula. (A) Gastroscope view of the thoracogastric airway fistula; (B) bronchoscope view of the thoracogastric airway fistula; (C) computed tomography of the thoracogastric airway fistula; (D) length of the tracheal fistula; and (E) left main bronchus intubation via an extended Parker flex-tip tube, and the right main bronchus with a balloon-tip bronchial blocker.
case_images: fsurg-09-959527-g001.jpg
case_images: PMC9679631_01_fsurg-09-959527-g001.jpg
case_images: F1
case_images: The use of a bronchoscope and gastroscope confirmed a large fistula (3.5 cm x 1.7 cm) 5 cm below the glottis, and its inferior margin was 2.5 cm above the carina (Figure 1). Computed tomography showed the fistula with upper and lower edges at 5 cm and 2.5 cm away from the glottis and the carina (Figure 1D). After consultation with surgeons, we decided to intubate a 6.5 extended Parker Flex-Tip Tube (total length 34 cm, Wellead ; Well Lead Medical Co., Ltd., Guangzhou, China) into the left main bronchus and a 9Fr bronchial blocker (Wellead ; Well Lead Medical Co., Ltd.) to occlude the right main bronchus (Figure 1E). An additional 10 cm extension limb (7.5# single-lumen tube, Wellead ; Well Lead Medical Co., Ltd., cut short into 10 cm) was used for connecting the circuit and the endotracheal tube (Supplementary Figure S1).