Smesseim Illaa, van Beelen Sophia, van Dieren Jolanda M, Hartemink Koen J, van Sandick Johanna, Burgers Jacobus A
Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Thoracic Oncology, Leiden University Medical Center, Leiden, the Netherlands.
Respir Med Case Rep. 2025 Jan 29;53:102169. doi: 10.1016/j.rmcr.2025.102169. eCollection 2025.
Broncho-esophageal fistulas (BEFs) are a rare but serious complication that can occur after esophagectomy, often resulting in aspiration, respiratory issues, and infection. Management depends on fistula size and location, with options including conservative treatments, surgical closure and stenting. Conventional treatment involves esophageal stents, which may be insufficient for larger or more complex fistulas. This case report describes the first use of a 3D-printed airway stent in combination with an esophageal stent to treat a broncho-esophageal fistula. A 70-year-old patient with distal esophageal adenocarcinoma, treated with neoadjuvant chemoradiation, underwent robot-assisted minimally invasive esophagectomy. The procedure was complicated by a broncho-esophageal fistula, leading to multiple interventions. Despite dual stenting with a custom 3D airway stent, the fistula persisted, and the patient was transitioned to supportive care due to disease progression. This case, the first to use a 3D-printed airway stent for a broncho-esophageal fistula, demonstrates that the stent did not achieve closure, likely due to excessive pressure against the endobronchial wall. This underscores the need for improved 3D stent designs, offering important insights for interventional pulmonologists.
支气管食管瘘（BEF）是一种罕见但严重的并发症，可发生在食管切除术后，常导致误吸、呼吸问题和感染。治疗方法取决于瘘管的大小和位置，包括保守治疗、手术闭合和支架置入等选择。传统治疗方法包括使用食管支架，但对于较大或较复杂的瘘管可能并不足够。本病例报告描述了首次使用3D打印气道支架联合食管支架治疗支气管食管瘘的情况。一名70岁的远端食管腺癌患者，接受了新辅助放化疗，随后接受了机器人辅助微创食管切除术。手术因支气管食管瘘而复杂化，导致多次干预。尽管使用了定制的3D气道支架进行双支架置入，但瘘管仍然存在，由于疾病进展，患者转而接受支持治疗。本病例是首次使用3D打印气道支架治疗支气管食管瘘，表明该支架未能实现闭合，可能是由于对支气管内壁的压力过大。这凸显了改进3D支架设计的必要性，为介入肺科医生提供了重要的见解。
