Volume 3, Issue 8, Pages (August 2018)

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Volume 3, Issue 8, Pages 241-243 (August 2018) Successful endoscopic closure of chronic nonmalignant tracheoesophageal fistula by use of a novel circumfistular endoscopic submucosal dissection and ligation strategy Yan Chen, MD, Yuting Meng, MM, Yunfeng Song, MM, Feng Liu, MD, Duowu Zou, MD VideoGIE Volume 3, Issue 8, Pages 241-243 (August 2018) DOI: 10.1016/j.vgie.2018.05.006 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Preoperative examinations. A, Pulmonary CT view showing a tracheoesophageal fistula in the right upper-lobe apex. B, Esophagoscopic view showing a diverticulum at the right wall of the esophagus (23 cm lateral to the mouth). C, Contrast esophagography demonstrating a tracheoesophageal fistula. VideoGIE 2018 3, 241-243DOI: (10.1016/j.vgie.2018.05.006) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Circumfistular endoscopic submucosal dissection and ligation. A, Circumferential incision of the mucosa about 1.5 cm lateral to the fistula and submucosal dissection to about 0.5 cm lateral to the fistula. B, Destruction of the mucosa surface by argon plasma coagulation. C, Ligation of the remaining tissues by an endoloop snare. D, Sealing the destroyed mucosa with hemoclips. VideoGIE 2018 3, 241-243DOI: (10.1016/j.vgie.2018.05.006) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Follow-up examinations 3 months postoperatively. A, Surveillance endoscopic view showing satisfactory wound healing and successful closure of the fistula. B, Contrast esophagography showing no leakage of contrast agent. VideoGIE 2018 3, 241-243DOI: (10.1016/j.vgie.2018.05.006) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions