Management of Malignant Esophagorespiratory Fistula

Lolley, David M.; Ray, Jefferson F.; Ransdell, Herbert T.; Razzuk, Maruf A.; Urschel, Harold C.

doi:10.1016/s0003-4975(10)63600-4

Cited by 57 publications

(15 citation statements)

References 8 publications

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“…12 Therefore, successful CRT for patients with malignant fistulae might have a survival advantage over supportive care. Indeed, in this study, the median survival time from the time of fistula diagnosis in Group A (238 days) obviously was longer than that presented in previous reports of patients receiving supportive care [1][2][3][4] and radiotherapy alone. 5 This result suggests that CRT is not absolutely contraindicated for patients with malignant fistulae and is even beneficial.…”

Section: Discussioncontrasting

confidence: 65%

“…The median survival for an untreated malignant fistula ranges from only 1 week to 6 weeks, [1][2][3][4] and the majority of patients with fistulae die of pulmonary complications. 18 Although chemotherapy and/or radiotherapy has been considered to be a contraindication, closure of the fistula by these treatments has been reported in some cases.…”

Section: Discussionmentioning

confidence: 99%

“…Many patients with malignant fistulae will die of a combination of aspiration, malnutrition, and sepsis with very short median survival times ranging from 1-6 weeks. [1][2][3][4][5] Surgical resection of the tumor is impossible, and therefore many various palliative treatments have been reported, including the use of esophageal endoprostheses, 6,7 self-expandable or nonexpandable metal stents, [8][9][10] enteric interposition, fistula exclusion, 3 and supportive treatment with or without enterostomy. Chemotherapy and radiotherapy have been considered to be contraindicated because they do not produce immediate benefits for these patients and actually may hasten death.…”

mentioning

confidence: 99%

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Concurrent chemoradiotherapy for esophageal carcinoma patients with malignant fistulae

Muto

Ohtsu

Miyamoto

et al. 1999

Cancer

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Concurrent chemoradiotherapy for esophageal carcinoma patients with malignant fistulae

Muto

Ohtsu

Miyamoto

et al. 1999

Cancer

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“…In the case of esophageal or bronchial cancer, surgical treatment of fistulae is not generally possible, as in these cases the tumors are too far advanced, and palliative operative measures are accompanied by a 50% mortality rate [11][12][13]. For this reason, endoscopic placements of tubes/stents are the method of choice [14,15]. In most cases, palliative endoscopic procedures rapidly improve the symptoms which, in view of the often expected short life-span, is crucial for the quality of life.…”

Section: Discussionmentioning

confidence: 99%

Treatment of an Esophagorespiratory Fistula by Insertion of an Esophageal Montgomery and Tracheal Dynamic Stent after Failure of Conventional Endoprosthesis

Neuhaus¹,

Kau

Hauck

et al. 1998

ORL

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Esophagorespiratory fistulae at the adult age can develop through malignant tumor growth, endoscopy, bougienage, laser therapy, or through a radiochemotherapy. We report a female patient with inoperable bronchial cancer, who developed a symptomatic esophagorespiratory fistula during radiochemotherapy with cisplatin. At first, conventional plastic tubes and then novel selfexpanding silicone-coated Gianturco-Song stents were used in an unsuccessful attempt to close the fistula. After the extraction of two Gianturco-Song stents, the insertion of a Montgomery-Salivary bypass stent in the esophagus and a dynamic stent in the trachea resulted in a permanent occlusion of the fistula. This case demonstrates that Montgomery-Salivary bypass stents do not tend to migrate due to their characteristic shape and self-fixation, and that the novel self-expanding, silicone coated Gianturco-Song stents can be extracted with rigid endoscopy if necessary.

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“…An esophagopulmonary fistula (EPF) from locally advanced esophageal cancer is a relatively rare condition in the field of thoracic disease [1]. An EPF is one of the lifethreatening complications of esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Esophagectomy and combined lobectomy with a covering latissimus dorsi muscle flap for an esophagopulmonary fistula due to advanced esophageal cancer: report of two cases

et al. 2013

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We herein describe the successful surgical treatment of two cases of esophagopulmonary fistula (EPF) due to esophageal cancer. Case 1: A 76-year-old man was diagnosed by computed tomography (CT) with an EPF due to esophageal cancer. Initially, antibiotics were given and enteral nutrition was administered. After 12 days, an esophageal stent was implanted. After 20 days, esophagectomy combined with a right middle-lower lobectomy with a covering latissimus dorsi muscle flap (LDMF) was performed. Case 2: A 54-year-old man was given induction chemoradiotherapy (CRT) for advanced esophageal cancer. Forty days after CRT, the patient developed a fever and was diagnosed with an EPF due to esophageal cancer based on CT findings. An emergency esophagectomy combined with a right lower lobectomy with covering by a LDMF was performed. The LDMF was useful to prevent postoperative complications, such as bleeding due to vessel rupture or bronchial stump fistula.

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Management of Malignant Esophagorespiratory Fistula

Cited by 57 publications

References 8 publications

Concurrent chemoradiotherapy for esophageal carcinoma patients with malignant fistulae

Concurrent chemoradiotherapy for esophageal carcinoma patients with malignant fistulae

Treatment of an Esophagorespiratory Fistula by Insertion of an Esophageal Montgomery and Tracheal Dynamic Stent after Failure of Conventional Endoprosthesis

Esophagectomy and combined lobectomy with a covering latissimus dorsi muscle flap for an esophagopulmonary fistula due to advanced esophageal cancer: report of two cases

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