In life, many people eat and drink quickly and like to swallow. This is not only easy to cause indigestion and obesity, but also may lead to esophageal tracheal fistula, which can easily cause aspiration pneumonia, and nutritional intake can not meet the needs of the body, bringing serious impact on the patient’s life and physical condition, and even life-threatening. The first thing you need to do is to get a good idea of what you’re looking for. The patient’s surname is Zhan, a native of Changshan, just turned 60 years old this year. More than a year ago, he was too anxious to drink water and suddenly found choking and coughing. At that time, he thought it was just an ordinary choking cough, but he didn’t expect to cough all the time and it was very painful. After going to the local hospital and having an esophagogram and chest CT, he was diagnosed with an esophagotracheal fistula. The normal esophagus is located behind the trachea and is separated by loose tissue to ensure that the two channels of eating and breathing do not interfere with each other. However, a congenital or acquired lesion inside or outside the esophagus causes the esophagotracheal tube to be connected, which is medically known as “esophagotracheal fistula”. It can lead to the inability to eat normally, just like the feeling of coughing violently when eating or drinking water inadvertently into the trachea, which is very unpleasant and can easily cause aspiration pneumonia, and the nutritional intake cannot meet the needs of the body, which can even be life-threatening. Clinically, the incidence of esophagotracheal fistula is not high, but the treatment is quite tricky, and at that time the local hospital recommended transferring to a large hospital for treatment. Mr. Zhan later went to a major hospital in Shanghai, where doctors placed a temporary stent in his esophagus to seal the fistula. After the treatment, Mr. Zhan resumed normal eating and was overjoyed. But the good times did not last long, and after the surgery he always felt an unexplainable discomfort behind his sternum, and after only one week, he again choked on his food. The examination revealed that the temporary stent placed in the esophagus had slipped and detached from the fistula, so Mr. Zhan had to operate again to remove the stent. After two surgeries, the problem of esophagotracheal fistula was still not solved, and Mr. Zhan was extremely frustrated as he could only sustain his life by feeding nutrition through the tube above his belly. Later, after many inquiries, Mr. Zhan came to the Thoracic Surgery Department of Hangzhou First Hospital, where he was seen by Director Li Hu, Jiang Hong and Deputy Director Wang Guoqing, who fully understood the patient’s condition and carefully reviewed the chest CT and esophagogram films. We found that the fistula connected the esophagus to the right lower lung, resulting in partial shunting of secretions and chyme in the esophagus to the lung, causing recurrent inflammation in the lung, which led to symptoms of infection such as coughing, coughing and fever, and limiting the patient’s normal eating. However, the current inflammation in the lung is very limited and has not spread to the thoracic cavity, which is still within the controllable range. If only a temporary closure of the fistula in the esophagus is taken, the symptoms are temporarily relieved, but it is not a permanent solution. Only surgical removal of the sinus tract and complete closure of the esophageal and tracheal breaches can solve the problem at its root. We developed a surgical treatment plan for Mr. Zhan, but Mr. Zhan was at high risk for surgery due to his prolonged inability to eat normally through the mouth, malnutrition, and underlying diseases such as hypertension. To ensure the safety of the surgery, the thoracic surgery department developed a detailed treatment plan before surgery. After admission, Mr. Zhan received active nutritional support, antibiotic anti-infection treatment, and proper regulation of blood pressure lowering drugs, and his infection and nutritional status improved significantly, and his blood pressure was controlled and stabilized. The procedure was also very thrilling, as Mr. Zhan’s repeated inflammatory infections led to adhesions in the chest cavity, which made it impossible to operate at first, but the two directors still dissected the sinus tract connecting the right lower lung to the esophagus as if they were butchers, and the right lower lung and esophagus were unharmed. Finally, the sinus tract that existed in Mr. Zhan’s right chest for many years was completely removed, and the integrity and function of the esophagus and right lower lung were restored. Now, Mr. Zhan has been discharged from the hospital for more than a month, and no longer has to be incontinent, finally realizing his wish to enjoy food and regain his health.