Successful closure of a complex tracheoesophageal fistula: An endoscopic intervention strategy based on tracheal stent transition.

A tracheoesophageal fistula (TEF) is an abnormal connection between the trachea and esophagus, which is an intractable clinical challenge associated with a poor prognosis and a high mortality. We report the successful closure of a complex, large-diameter TEF in a male patient in his late 60s following radical esophagectomy, with initial surgical and esophagoscopic interventions considered unfeasible. A tracheal stent was placed to cover the fistula as a bridging therapy, followed by definitive closure using an over-the-scope clip (OTSC). The tracheal stent was removed at the 5-month follow-up, and no serious complications were observed during or after endoscopic management. For complex TEFs that are not amenable to surgical repair or esophagoscopic closure, tracheal stent placement serves as a bridging therapy, thereby providing a window for subsequent interventions. The combined strategy of tracheal stenting with the OTSC provides a minimally invasive and highly effective treatment option for complex TEFs through multidisciplinary collaboration.