Thoracoscopic Resection of a Giant Tracheal Pouch After a Previous Tracheoesophageal Fistula Repair

Abstract

A 7-year-old girl with trisomy 21 and who had a tracheoesophageal fistula repaired via a right posterolateral thoracotomy incision at birth suffered from recurrent pulmonary infections. A bronchoscopy demonstrated a giant tracheal pouch at the site of the previous fistula, which pooled respiratory secretions. It was hypothesized that this pooling of mucus and bacteria was the source of her recurrent infections. She underwent a thoracoscopic resection of the tracheal pouch using two 5-mm and one 12-mm pouch. The procedure took 65 minutes and was accomplished without complication. No chest tube was left and the patient was discharged on the first postoperative day. She has no longer had problems with recurrent infections. This video demonstrates that reoperative tracheal surgery can be safe and effective. No competing financial interests exist. Runtime of video: 4 mins