Figure 2

Second endoscopic approach (endoscopic view): at this point, a shortened oesophageal self-expanding plastic stent (Polyflex, Boston Scientific) has been inserted upside down in the large diameter trachea. The digestive end of the fistula is closed using a folded collagen mesh (Cook), Fibrin glue sealing and approximation of the walls with intraparietal cyanoacrylate injection.