Anastomotic fistula is one of the most serious postoperative complications of esophageal cardia disease. For patients with intermediate to advanced fistula, most scholars advocate conservative treatment. Despite the aggressive combination of fasting, closed chest drainage, jejunostomy, nutritional support and anti-infection, most patients have a poor prognosis, and only a few patients are cured by long-term conservative treatment or second-stage surgery. Therefore, esophagogastric anastomotic fistula has been a very difficult problem in thoracic surgery. The successful application of silicone wrapped stent for malignant stenosis with esophagotracheal fistula has laid the foundation for the clinical application of endoesophageal stent. The group was treated with a fully-coated, retrievable endoesophageal stent without reoperation, and most patients tolerated the treatment. Choice of treatment timing: For patients with anastomotic fistula that cannot be operated again, stenting should be actively used without loss of time as long as conditions allow, which can eliminate the contamination of the thoracic cavity by gastric juice and facilitate the control of local and thoracic infection of the fistula, preferably 1 week after surgery, exactly the time needed for anastomotic healing. Choice of stent type: Due to the anastomosis between the esophagus and the stomach, there is a large difference in the luminal diameter between the two, and the location and size are different. In addition to the choice of flare-type wide skirt stent 6-8, the diameter of the stent should be larger than the diameter measured under gastroscopy to increase the stability of the stent and the blocking effect. The length of the stent should be selected according to the anastomotic position, generally exceeding 30-40 mm each of the upper and lower edges of the anastomotic fistula, and if the position is high, the stent should be as short as possible to avoid increasing the patient’s discomfort. For special shapes and parts can be customized with special design, such as: cervical anastomotic fistula can be customized with smaller stent with flared mouth and diameter. Effective closed chest drainage, anti-infection and supportive treatment: The choice of flushing solution and the number of flushes per day are determined on a case-by-case basis. For patients with heavy chest infection, in addition to the usual flushing solution, flushing with 1% iodophor and 1.5% hydrogen peroxide can be used, followed by saline flushing. The bacterial culture of the chest drainage fluid is the basis for selecting the intravenous application of antimicrobial agents. Fluids such as fish soup and chicken soup are dripped through the duodenal nutrition tube to replenish nutrition, electrolytes and water, while reducing the financial burden on the patient. Of course, fresh plasma and human albumin are important to support treatment. Factors affecting the success of fistula plugging: In addition to the patient’s general nutritional status, choice of stent type, anti-infective and supportive therapy, the degree of fistula plugging by the stent depends on the location and size of the fistula; if the fistula is located on the esophageal side, it is better plugged by the stent, whereas if the fistula is located on the gastric side, the plugging effect of the stent is very limited. However, the stent placed at both ends of the fistula acts as a “bridge” for the crawling growth of mucosal tissue, which facilitates the healing of the fistula, and then increases the plugging effect by decompressing the gastric tube to make the residual stomach in the chest cavity free of tension. In our two cases of anastomotic fistula combined with gastric stump fistula, the first stent was used to seal the anastomotic fistula, the upper edge of the second stent was placed 20 mm inside the first stent, and the lower edge crossed the artificial esophageal diaphragmatic fissure, so that the residual stomach was left open, and the negative pressure of the thoracic cavity made the stomach in the thoracic cavity tension-free, which facilitated the healing of the fistula. Here, it is recommended that the diameter of the artificial esophageal diaphragmatic fissure should be as close to the original size as possible. Application of acid-suppressing drugs: After stent placement, acid-suppressing drugs with proton pump are routinely applied to reduce gastric acid secretion and decrease the occurrence of reflux esophagitis and gastric mucosal erosion and ulceration, which also facilitates fistula healing. The timing and nature of feeding: The timing of feeding depends on the specific situation. Before feeding, a compound pantothenic glucosamine esophagogram should be performed to determine the success of blockage before feeding. In our group, we generally choose to eat after 5-10 days postoperatively (considering that the stent and esophageal mucosa can be fully apposed to each other). Follow the order of paste diet, semi-liquid soft food universal food, but chew and swallow slowly to reduce the incidence of stent dislocation. Management of complications: postoperative retrosternal discomfort or pain often occurs in patients with a high anastomotic position and is usually relieved by symptomatic treatment for 3 to 7 days. All patients with hemorrhage occurred after eating, not listening to the doctor’s medical advice, after the appearance of food that could not be entered without permission, and again bedside gastroscopy all found varying degrees of erosion and scattered bleeding spots in the residual gastric mucosa, which were cured by blood transfusion and hemostatic drug treatment. All patients with downward stenting occurred after eating, all due to improper eating, and the stent was immediately adjusted to its original position under gastroscopy. The time to remove the stent: depends on the specific case, mainly based on the size of the fistula, the degree of infection, and the physical condition. Our experience is that it is generally safer to remove the stent after 4-6 months. In conclusion, retrievable overlapping stents for the treatment of esophagogastric anastomotic fistula are a simple, inexpensive, and accurate treatment method that is worthy of clinical application.