A Hem-o-Lok-Induced Tracheoesophageal Fistula Cured by Temporary Airway Stenting Modified With Three-Dimensional Printing

We present the case of a fistula between the trachea and the esophagogastric anastomosis in a 58-year-old man after esophagectomy. A Hem-o-Lok clip (Teleflex, Morrisville, NC) used at the time to ligate the azygos vein was discovered by esophagoscopy and bronchoscopy to be eroding into both structures. A covered self-expandable Y-shaped metallic tracheobronchial stent was customized with a three-dimensional printed airway model and inserted in place with endoscopic injection of fibrin glue to the anastomotic site. The stent was withdrawn 64 days after implantation, with complete healing of the fistula. (C) 2018 by The Society of Thoracic Surgeons