[Inflammatory and neoplastic esophagotracheal fistula. Intubation or surgery?].
There are two principal aetiologies for oesophago-tracheal fistulae: cancer of the oesophagus opening into the airways and assisted ventilation (tracheotomy or nasotracheal intubation). Oesophago-tracheal fistulae are rare. Over a period of 6 years, the authors have treated 9 neoplastic oesophago-tracheal fistulae in a series of 150 cases of oesophageal cancer and 2 inflammatory oesophago-tracheal fistulae out of a series of more than 20 stenoses of the same nature. The two types of oesophago-tracheal fistulae have the same degree of severity but very different significance, treatment and prognosis: neoplastic oesophago-tracheal fistulae, an advanced, often terminal form of oesophageal cancer, justify palliative treatment to exclude the respiratory tract. Endoscopic intubation of the oesophagus is generally appropriate treatment. Exceptionally, a surgical bypass of the oesophagus may be proposed. Inflammatory oesophago-tracheal fistulae require treatment to restore the continuity of the trachea and oesophagus in patients with respiratory autonomy. In agreement with H. Grillo, we consider treacheal resection-suture and repair of the oesophageal defect to constitute the most satisfactory procedure.
Richelme
H
H
Benchimol
D
D
Mouroux
J
J
Bernard
J L
JL
Pulcini
A
A
D000328:Adult; D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications; D004947:Esophagus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation / Q000379:methods*; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D014140:Tracheotomy / Q000009:adverse effects
Fistules oeso-trachéales inflammatoires et néoplasiques. Intubation ou chirurgie?