Tracheo-esophageal fistula complicating carcinoma of the esophagus.
In a 35-year review of 557 patients with esophageal carcinoma, 26 tracheal esophageal fistulas were encountered. Seventeen arose among patients with advanced disease or poor performance status and these patients were given comfort measures only. Treatment was attempted in 9 patients, 4 of whom died peri-operatively. The remaining 5 avoided early pulmonary deaths. In principle, esophageal exclusion and bypass should provide the best palliation in patients whose performance status permits it, but extensive surgical procedures are futile in patients with established pulmonary sepsis. For most patients, not candidates for exclusion procedures, endoprostheses are more appropriate.
Hause
D W
DW
Department of Surgery, Kaiser Permanente Medical Center, Los Angeles, California.
Kagan
A R
AR
Fleischman
E
E
Harvey
J C
JC
D002140:California / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D010166:Palliative Care; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014138:Tracheoesophageal Fistula / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy