Successful Treatment of a Case of Super-High Malignant Esophago-tracheal Fistula with Sigma Fully Covered Esophageal Stent Placement :Case Report

Shupei Li ¹ Qi Zhai ² Ya Yang ² Huafei Li ² Juan Xu ^2* Ying Zhang ^2* Ji Xuan ^1,2*

• ¹ Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Liaoning Province, China
• ² Affiliated Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, China

AbstractBackgroundEsophageal cancer, as one of the most frequently occurring malignancies globally, often leads to esophageal stenosis and fistulas post-surgery or radiotherapy, significantly impacting patients' quality of life and prognosis. In particular, super-high esophageal fistulas represent a clinically challenging issue that urgently needs to be addressed.Case SummaryThis study reports on a 72-year-old female patient who developed anastomotic stenosis following esophageal cancer surgery. Endoscopic exploration revealed that the esophageal inlet was approximately 17 cm from the incisors, with the anastomotic site located 20 cm from the incisors and being stenotic, rendering endoscope passage impossible. An ultra-thin gastroscope was then used, showing the stenosis at 20-22 cm. Our center successfully managed the high anastomotic stenosis with a Sigma fully covered esophageal stent. Subsequently, the patient experienced anastomotic recurrence and multiple esophageal-tracheal fistulas, which were successfully sealed with the same type of stent. A stent replacement was performed one year later, successfully improving the patient's quality of life.ConclusionThis study demonstrates the successful management of a super-high esophageal-tracheal fistula using a Sigma fully covered metallic stent.