VA01.3. Left Mainstem Bronchus Iatrogenic Injury: Tracheobronchoplasty and Repair With Bovine Pericardium Patch

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ID: 326087
2026
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Ranked #248 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications Video Description This video describes the thoracoscopic repair with bovine pericardial patch of an iatrogenic injury to the left mainstem bronchus during esophagectomy, and outlines a safe post-operative recovery course. We present a 72-year-old female with a diagnosis of distal esophageal adenocarcinoma. Following four cycles of neoadjuvant FLOT chemotherapy, she underwent minimally-invasive Ivor Lewis esophagectomy via a laparoscopic and thoracoscopic approach. A double-lumen endotracheal tube was placed at intubation, and the abdominal phase proceeded without issue. During the subcarinal lymphadenectomy in the right thoracic portion, the balloon of the left bronchial portion of the endotracheal tube came into view, which had perforated the left mainstem bronchus. In the context of a stable, well-ventilated patient, the esophageal mobilisation was completed to facilitate wide access to the area for repair. With a jet ventilator catheter passed distal to the defect via the endotracheal tube, the balloon was deflated and the defect edges debrided. A bovine pericardial patch was secured with two continuous 3-0 barbed sutures, taking care to avoid undue tension or redundancy. Following a negative leak test, the gastric conduit was delivered and the esophago-gastric anastomosis fashioned 5cm above the level of airway injury. Post-operatively the patient spent one day on ICU followed by seven days on the ward. Diet was commenced on day 4 following an oral contrast study demonstrating no anastomotic leak. Iatrogenic airway injury from intubation is a rare but serious complication of thoracic surgery. Knowledge of ventilatory techniques and repair strategies are crucial in safely managing this event.
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Authors Heidi Paine, Carmen Mueller, Lorenzo Ferri
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.432
URL
https://academic.oup.com/dote/article-pdf/39/Supplement_1/doag077.432/70760457/doag077.432.pdf
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