title: Novel multimodality endoscopic closure of postoperative esophageal fistula.
abstract: BACKGROUND
  Esophageal fistula following esophagectomy is associated with significant morbidity and mortality.
  
  
  METHODS
  We present the case of a 71-year-old man who underwent salvage Ivor-Lewis esophagectomy, following definitive chemoradiotherapy 1 year previously. On postoperative day 9 the patient complained of chest pain, and a CT scan demonstrated extravasation of oral contrast from the gastric conduit into the right chest. A right chest drain and fully covered esophageal stent were placed at this time. Despite these measures, after 8 weeks, the esophageal fistula persisted. Ultimately, fistula closure was achieved using an interventional radiology-guided, endoscopically placed over-the-scope clip (OTSC). The patient had no further complications and was well at 3 months follow-up.
  
  
  CONCLUSIONS
  The case reported herein describes this novel, combined-modality approach to esophageal fistula closure.
  
  
  CONCLUSIONS
  This case report demonstrates a novel, minimally invasive, multidisciplinary approach to the closure of a post-esophagectomy anastamotic leak.
authors.affiliation: Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
authors.forename: Sheraz R
authors.initials: SR
authors.lastname: Markar
authors.forename: Richard
authors.initials: R
authors.lastname: Koehler
authors.forename: Donald E
authors.initials: DE
authors.lastname: Low
authors.forename: Andrew
authors.initials: A
authors.lastname: Ross