Management of a cervical tracheoesophageal fistula with a modified self-expanding metal stent: Report of a case

Abstract

KEYWORDScervical esophageal cancer; double esophageal stent; esophageal stent; self-expanding metal stent; tracheoesophageal fistula Summary Treatment of tracheoesophageal (TE) fistula is always a challenge, in particular TE fistula caused by malignancy. In the past decade, the development of a self-expanding metal stent (SEMS) has made management of esophageal stenosis or perforation much easier. Nevertheless, management of a cervical esophageal lesion is still debatable. A cervical esophageal stent may compromise the upper esophageal sphincter (UES) function and is usually listed as a contraindication. Here, a 53-year-old male had cervical esophageal cancer complicated with a TE fistula. After initial management with a SEMS, the patient had temporary improvement, but later suffered a recurrent TE fistula. The TE fistula was successfully managed by the placement of a second modified SEMS just below the UES without removal of the previous SEMS. The patient tolerated the procedure well and regained proper swallowing function.