RT Book, Section
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
SR Print(0)
ID 1105839211
T1 Management of Malignant Esophageal Fistula
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105839211
RD 2024/04/25
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.