# Endoscopic treatment with lumen-apposing metal stent in a patient with esophageal stricture and esophagobronchial fistula: a case report

## TL;DR

A lumen-apposing metal stent was successfully used to treat a complex post-surgery esophageal condition involving a stricture and fistula.

## Contribution

This is the first reported case of using LAMS for malignant esophageal stricture and postoperative fistula.

## Key findings

- LAMS effectively relieved the obstruction and sealed the esophagobronchial fistula.
- The patient experienced sustained symptom resolution for 4 weeks after the procedure.
- LAMS placement is a technically feasible and minimally invasive treatment option.

## Abstract

Endoscopic interventions for postoperative esophageal strictures and fistulas are inherently challenging. The use of conventional self-expandable metallic stents has been restricted due to high migration rates. There has been no report about malignant esophageal stricture and postoperative fistula managed with a lumen-apposing metal stent (LAMS). We present a case of refractory postoperative anastomotic stricture and esophagobronchial fistula following esophagectomy. Endoscopic deployment of a LAMS effectively relieved the obstruction and sealed the fistula, with the patient tolerating the procedure well and experiencing sustained symptom resolution for 4 weeks. This case suggests the potential role of LAMS in maintaining luminal patency and sealing fistulas. Endoscopic ultrasound-guided LAMS placement should be a technically feasible, effective and minimally invasive approach for postoperative esophageal stenosis and fistula.