Successful Closure of a Refractory Gastrobronchial Fistula Combining Endoscopic Submucosal Dissection and Argon Ablation Plus Single-Loop-and-clip Techniques

Text A 78-year-old male, late fistula after Ivor-Lewis esophagectomy, communication between gastroplasty-right bronchus. Refractory to several endoscopic therapies (clips, tissue adhesive, stents). Fistula closure after combination of submucosal dissection assisted by clip-with-line traction technique of the mucosal flap (to allow deep dissection) plus over-the-scope-clip; and ablative technique (argon plasma coagulation) with single loop-and-clips technique (KING-Closure) In two consecutive endoscopic procedures. Comments: Successful treatment of a chronic persistent fistula between the digestive tract and the trachea-bronquial tree, by combination of various endoscopic closure techniques. [1]