[Endoscopic purse-string suture with nylon loop combined with metallic clips for esophagojejunal anastomotic thoracic...

Objective: To investigate the treatment of esophagojejunal anastomotic thoracic fistula after laparoscopic radical total gastrectomy in patients with cardiac carcinoma. Methods: A 58-year-old male patient with cardiac carcinoma underwent laparoscopic radical total gastrectomy, Roux-en-Y esophagojejunostomy and regional lymph node dissection, and was complicated with esophagojejunal anastomotic thoracic fistula. The fistula was successfully closed using endoscopic purse-string suture with nylon loop combined with metallic clips. Results: After active anti-infection, thoracic puncture and drainage, and organ function support to stabilize the condition, endoscopic purse-string suture with nylon loop combined with metallic clips was performed twice to close the fistula. At 3 months of follow-up, the original fistula was completely closed after removal of metallic clips, with a superficial ulcer at the local site. No recurrence was observed during the 1-year follow-up. Conclusion: Endoscopic purse-string suture is a safe and effective minimally invasive method for the treatment of esophagojejunal anastomotic thoracic fistula.