Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 May;53(3):361-365.
doi: 10.5946/ce.2019.106. Epub 2019 Oct 28.

Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management

Nonthalee Pausawasdi  1 , Chotirot Angkurawaranon  1 , Tanyaporn Chantarojanasiri  1 , Arunchai Chang  1 , Wanchai Wongkornrat  2 , Somchai Leelakusolvong  1 , Asada Methasate  1   3
Affiliations
Case Reports

Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management

Nonthalee Pausawasdi et al. Clin Endosc. 2020 May.

Abstract

Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

Keywords: Esophagorespiratory fistula; Over-the-scope clip; Tracheoesophageal fistula.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no financial conflicts of interest.

Figures

Fig. 1.
Fig. 1.
(A) Endoscopic image demonstrates tracheoesophageal fistula (TEF) in the upper esophagus. (B) Placement of 18×120 mm PolyflexTM (Boston Scientific, Natick, MA, USA) stent.
Fig. 2.
Fig. 2.
(A) Fully covered 18×120 mm WallflexTM (Boston Scientific, Natick, MA, USA) stent in place. (B) Persistent fistula identified after WallflexTM stent removal. TEF, tracheoesophageal fistula.
Fig. 3.
Fig. 3.
(A) Endoscopic view of fistula closure with an over-the-scope clip. (B) Contrast injection under fluoroscopy shows no contrast leakage after placement of the clip
Fig. 4.
Fig. 4.
Follow-up water-soluble esophagogram. (A) Contrast study performed at 4 weeks after treatment showing no leakage. (B) Contrast study performed at 16 weeks after treatment showing no leakage.
See this image and copyright information in PMC

References

    1. Santosham R. Management of acquired benign tracheoesophageal fistulae. Thorac Surg Clin. 2018;28:385–392. - PubMed
    1. Law R, Wong Kee Song LM, Irani S, Baron TH. Immediate technical and delayed clinical outcome of fistula closure using an over-the-scope clip device. Surg Endosc. 2015;29:1781–1786. - PubMed
    1. So BJ, Adler DG. Closure of a chronic, non-healing tracheoesophageal fistula with a new over-the-scope clip. ACG Case Rep J. 2014;2:18–20. - PMC - PubMed
    1. Silon B, Siddiqui AA, Taylor LJ, Arastu S, Soomro A, Adler DG. Endoscopic management of esophagorespiratory fistulas: a multicenter retrospective study of techniques and outcomes. Dig Dis Sci. 2017;62:424–431. - PubMed
    1. Debourdeau A, Gonzalez JM, Dutau H, Benezech A, Barthet M. Endoscopic treatment of nonmalignant tracheoesophageal and bronchoesophageal fistula: results and prognostic factors for its success. Surg Endosc. 2019;33:549–556. - PubMed

Publication types

LinkOut - more resources