Successful closure of intractable tracheoesophageal fistula using a combination of a modified silicon stent and metallic stents

Abstract

Although surgery is the usual management strategy for acquired benign tracheoesophageal fistula, sometimes this approach is contraindicated or the patient declines surgical management. In this report, we describe a case of a patient with tracheoesophageal fistula at the level of the carina due to bronchial arterial infusion chemotherapy. Closure could not be achieved in response to multiple treatment strategies, including airway stenting, esophageal stenting, occlusion with microcoils, or cyanoacrylate glue. We subsequently achieved closure of this fistula through the combination of a modified silicon stent and metallic stents.

Tracheomegaly and tracheosephagial fistula following mechanical ventilation: A case report and review of the literature

“…There are several surgical treatment options available, including direct suturing of the esophageal defect, esophageal bypass, esophageal exclusion, and fistula resection. Additionally, fibrin sealants or glues have been utilized in small-opening fistulas [18] . In cases of advanced malignancies, palliative measures are usually employed including esophageal stenting and chemotherapy or radiation therapy to address dysphagia and the risk of pulmonary infections.…”

“…In cases of advanced malignancies, palliative measures are usually employed including esophageal stenting and chemotherapy or radiation therapy to address dysphagia and the risk of pulmonary infections. However, with procedures such as stenting, there is a high incidence of esophageal perforation due to frequent need of tumor dilation [18] .…”

Placement of self-expandable bifurcated metallic stents without use of fluoroscopic and guidewire guidance to palliate central airway lesions

“…Bifurcated stents are preferred when airway stenosis involves the carinal area, or when a tracheoesophageal fistula is present or a fistula might develop at the anastomotic site after operation. Rigid bronchoscopy must be used for stent placement in such situations [ 14 – 16 ]. In addition, team experience is important, and various maneuvers are required to prevent laceration of the airways, main vessels, and tracheobronchial wall when placing silicon stents [ 17 ].…”

Obstruction of the right stem bronchus due to ovarian local metastasis: a 5-year follow-up

“…There is also the case where a fistula might develop at the anastomotic site after operation. Moreover; rigid bronchoscopy is more efficient in such situations (18)(19)(20). It is very important that these procedures take place in centers with experience in order to avoid laceration of the airways, tracheobronchial wall and main vessels damage (21).…”