title: [Non-malignant esophagotracheal fistulas in adults. Experience with 35 cases].
abstract: Esophagotracheal fistula always constitutes a serious, life-threatening complication. Fistulae occurring during medical intensive care with mechanical ventilation are currently the most frequent. Their diagnosis was strongly suspected by clinical examination of the patient, but was always confirmed by endoscopy which revealed their exact site in relation to the vocal cords or carina, essential information for the choice of incision when it is decided to perform surgery. Twenty-five patients were treated medically. Treatment was always combined with gastrointestinal resting, control of gastro-oesophageal reflux and broad-spectrum systemic antibiotics. There were 19 deaths and 6 fistulae closed spontaneously. Three of these 6 patients developed a secondary tracheal stenosis, 2 of which were treated surgically by resection-anastomosis. Ten fistulae were closed surgically with a good long-term result. The indication for surgery was essentially based on the patients general and infectious status and on his or her respiratory autonomy. Technically, we always combined direct suture of the two organs with interposition of muscular or pleural tissue.
authors.affiliation: Service de Chirurgie Thoracique et des Maladies de l'Oesophge, Hôpital Saint-Marguerite, Marseille.
authors.forename: R
authors.initials: R
authors.lastname: Giudicelli
authors.forename: J M
authors.initials: JM
authors.lastname: Sainty
authors.forename: A
authors.initials: A
authors.lastname: Barthélémy
authors.forename: J F
authors.initials: JF
authors.lastname: Dumon
authors.forename: B
authors.initials: B
authors.lastname: Dupin
authors.forename: J C
authors.initials: JC
authors.lastname: Lapicque
authors.forename: P
authors.initials: P
authors.lastname: Fuentes
authors.forename: L
authors.initials: L
authors.lastname: Bordigoni
authors.forename: A
authors.initials: A
authors.lastname: Ballabio
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000628:therapy; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D012121:Respiration, Artificial / Q000009:adverse effects*; D014138:Tracheoesophageal Fistula / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Les fistules oeso-trachéales non malignes de l'adulte. Expérience de trente-cinq cas.