Successful endoscopic treatment of a tracheobronchial fistula following Lewis operation in a high-risk surgical patient: A clinical case report

Tracheobronchial fistulas (TBFs) are a rare but life-threatening complication following esophageal surgery, especially after Lewis esophagectomy. Traditional surgical approaches are associated with high risk, especially in patients with severe cardiovascular disease. We describe the clinical case of a 68-year-old patient with cardioesophageal cancer and multiple comorbidities who developed two tracheobronchial fistulas after Lewis surgery. Endoscopic treatment included bronchial occlusion, argon plasma coagulation, and the use of a large-pored hemostatic sponge. This stepwise and minimally invasive approach ensured complete closure of the fistulas without the need for repeat surgical intervention. This case demonstrates the effectiveness of modern endoscopic technologies in the treatment of complex fistulas in high-risk patients.