Management of esophagorespiratory fistula due to carcinoma esophagus with palliative intubation, gastric decompression and transgastric feeding jejunostomy.
BACKGROUND
Carcinoma esophagus with esophagorespiratory fistula has a poor prognosis. Water and food intake suffers and pulmonary contamination leads to lung infection. Treatment is essentially palliative.


METHODS
Thirty-five patients with esophagorespiratory fistula secondary to esophageal carcinoma were treated with palliative esophageal intubation, gastrostomy and transgastric feeding jejunostomy.


RESULTS
Esophageal prosthesis could be implanted in 34 patients. One patient died in the postoperative period. Twenty-nine patients were able to swallow saliva without leakage into the lungs. Only four patients were able to take full diet orally for any significant length of time. An 18-G needle inserted in the gastrostomy Malecot's catheter provided outlet for air in the stomach and prevented rise in intragastric pressure and gastroesophageal reflux. Transgastric feeding jejunostomy functioned satisfactory. Twenty patients were followed up; the average survival was 58 days (range 9-337 days).


CONCLUSIONS
Esophageal intubation, gastrostomy and transgastric feeding jejunostomy provide satisfactory palliation for patients with esophagorespiratory fistula secondary to carcinoma esophagus.
Sinha
K N
KN
Department of Surgery, King George's Medical College, Lucknow.
D000328:Adult; D000368:Aged; D004750:Enteral Nutrition / Q000379:methods; D004937:Esophageal Fistula / Q000150:complications / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007440:Intubation; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D016896:Treatment Outcome