TY - CHAP M1 - Book, Section TI - Management of Malignant Esophageal Fistula A1 - Magee, Mitchell J. A1 - Sonett, Joshua R. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann Y1 - 2015 N1 - T2 - Adult Chest Surgery, 2e AB - Malignant esophageal fistula occurs infrequently, yet remains one of the most challenging complications encountered in thoracic oncology. It may occur in the setting of complicated esophageal cancer, presenting at an advanced stage of disease, or as a complication of treatment. The fundamental tenets of successful management of any fistula, such as relief of distal obstruction, treatment of infection, nutrition, and treatment of underlying malignancy, should be kept in mind but unfortunately are inherent to the disease process and usually overwhelming for patient and clinician. Improvements in completely covered self-expanding metallic stents (SEMSs) and associated delivery systems have dramatically changed the approach to managing esophageal fistulae, particularly involving the tracheobronchial tree. Palliation and not cure is the objective in the majority of patients afflicted with this uniformly fatal complication, which most often occurs in the setting of advanced stage disease. A multidisciplinary approach to accurate and precise diagnosis and treatment is essential. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105839211 ER -