Army doctors perform high-risk airway stenting procedure to save cancer patient with fistula complication

Pune: Specialists at the Army Institute of Cardio-Thoracic Sciences (AICTS) have successfully treated an 56-year-old woman from Latur, the wife of a military veteran, who was suffering from advanced oesophageal cancer with a complication.

The patient’s condition had led to a life-threatening tracheoesophageal fistula, an abnormal passage between the food pipe and airway. The latter had severely compromised her breathing and placed her at constant risk of recurrent lung infections and respiratory failure, and she was in a critical state when she was admitted to the hospital.

According to doctors, such cases are extremely difficult to manage as both the airway and food passage become dangerously interconnected, making even routine breathing and swallowing a major challenge.

The multidisciplinary team at the institute on May 23 undertook a highly complex airway intervention using ECMO (Extracorporeal Membrane Oxygenation) support, a sophisticated life-support system that temporarily performs the function of the lungs and heart during critical procedures. Doctors then deployed a self-expanding metallic inverted Y-stent inside the airway to seal the abnormal communication and restore airflow.

Army doctors described the procedure as exceptionally demanding because the airway was critically narrowed and unstable due to the cancer invasion.

“Any manipulation inside the trachea carried the risk of complete airway collapse, massive bleeding or sudden respiratory arrest. Conventional ventilation during such procedures is often inadequate, making ECMO support crucial for maintaining oxygen supply throughout the operation,” said a senior doctor from AICTS, who was part of the surgical team.

“The insertion of an inverted Y-shaped metallic stent itself required extraordinary precision. The device had to be carefully navigated and positioned across the trachea and both main bronchi to maintain airway patency, while simultaneously sealing the fistula. Even minor misalignment could have led to airway obstruction or stent migration,” he added.

The doctor said, “The successful intervention immediately improved the patient’s breathing and significantly reduced the risk of further pulmonary complications, giving her a renewed chance at recovery and improved quality of life.”

The patient’s recovery was reported to be on track, and she was gradually being introduced to food, with discharge from the hospital likely on May 30.

“The case underlines the growing capability of military medical institutions in handling advanced and high-risk procedures, usually associated with specialised tertiary-care centres,” an AICTS official told TOI, adding, “The achievement reflects the Indian Army’s sustained investment in critical care, oncology and cardiothoracic expertise for serving personnel, veterans and their families.”

Commenting on the development, well-known pulmonologist Dr Nitin Abhyankar said, “This was a rare surgery. Army specialists using ECMO and inserting a stent in a cancer patient is a complex case. In civilian set-ups and hospitals, such cases are difficult due to multiple challenges and complications. This achievement gives confidence to doctors and, most importantly, hope to critical patients and their families. The entire medical team must be complimented.”