[Treatment of benign acquired esophagorespiratory fistula with through-the-clip device: a report of 2 cases and literature review].

Objective

To investigate the feasibility and clinical efficacy of through-the-scope clips(TTS Clips) closure technique for benign acquired esophagorespiratory fistulas.

Methods

The clinical data of 2 patients with benign acquired esophagorespiratory fistulas successfully treated at the Chuiyangliu Hospital Affiliated with Tsinghua University were retrospectively analyzed. The size and location of the fistula were assessed from the esophageal side. Argon plasma coagulation (APC) was used first to coagulate and trim the mucosa around the fistula margins to create a fresh wound surface, and also, to symmetrically relieve tension around the orifice for the bigger fistula. Finally, TTS Clips were applied to close the fistula under gastroscopy. Relevant literature was retrieved from PubMed, Wanfang, and CNKI databases to systematically analyze the current status and factors influencing healing of endoscopic clipping for benign acquired esophagorespiratory fistula.

Results

Both patients successfully underwent endoscopic closure with TTS Clips after thorough preoperative evaluation. One patient with a fistula <5 mm achieved clinical healing after one clipping procedure. while the patient with a 14 mm×8 mm fistula achieved clinical healing after three endoscopic clipping sessions over a 4-month period. Literature review revealed that endoscopic clipping has been extensively reported for gastrointestinal fistulas, while data on its application for benign tracheoesophageal fistulas remain scarce. Nevertheless, existing evidence supports the methodological feasibility of this approach for benign esophagorespiratory fistulas.

Conclusion

Endoscopic TTS clips closure for benign esophagorespiratory fistulas is a minimally invasive, repeatable and safe approach that can achieve clinical healing, representing an effective treatment option for this condition.