Successful multidisciplinary treatment of advanced esophageal cancer with tracheobronchial stenosis and bronchial fistula using a strategic combination of two types of airway stents: A case report

Abstract

Advanced esophageal cancer with tracheal invasion is associated with poor prognosis. However, airway stenting can effectively improve patients’ quality of life and enable the administration of anticancer treatment. Herein, we report a case of advanced esophageal cancer with severe tracheal stenosis and a tracheoesophageal fistula that was successfully managed using a combination of two different airway stents. A man in his fifties presented with throat discomfort and a 2-month history of weight loss. The patient was diagnosed with advanced esophageal cancer with severe stenosis at the tracheal bifurcation. Immediate and appropriate airway stenting allowed the patient to recover from a severely compromised airway. We used two types of airway stents (Y-shaped silicone and self-expandable covered metallic stents) to cover the tracheoesophageal fistula near the tracheal bifurcation and to expand the right main bronchial lumen. The Y-shaped silicone stent was carefully trimmed to fit the anatomical structure, ensuring optimal placement. The procedure was safely performed with veno-venous extracorporeal membrane oxygenation support. This case demonstrates the effectiveness of prompt, tailored airway intervention using combined stenting techniques in managing life-threatening complications of esophageal cancer. Early airway stabilization not only improves respiratory status but also facilitates further oncological treatment. J. Med. Invest. 73 : 528-532, August, 2026