Abstract
BACKGROUND: Carinal resection and reconstruction are complex surgical procedures often necessitated by tumors or other pathologies involving the tracheobronchial junction. Traditional approaches to these surgeries are highly invasive. The advent of uniportal video-assisted thoracoscopic surgery (VATS) along with the integration of extracorporeal membrane oxygenation (ECMO) offer potential advantages in reducing surgical trauma and improving outcomes. CASE PRESENTATION: A 42-year-old female patient was admitted to the hospital with the chief complaint of "chest tightness for 20 days". Enhanced chest CT revealed a soft tissue shadow on the tracheal bifurcation wall, protruding into the left main bronchus opening. After multidisciplinary discussions and the exclusion of surgical contraindications, we performed ECMO-assisted uniportal VATS carinal resection and reconstruction for the patient. The patient's postoperative course was uneventful, and she was discharged on postoperative day 4 with satisfactory respiratory function and no major complications. CONCLUSIONS: This case demonstrates the feasibility and potential benefits of combining ECMO support with uniportal VATS for complex carinal surgeries. The approach minimizes surgical trauma, ensures stable intraoperative conditions, and may enhance postoperative recovery. Further studies are warranted to validate these findings and establish standardized protocols for such advanced surgical techniques.