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  • Title: [Inflammatory and neoplastic esophagotracheal fistula. Intubation or surgery?].
    Author: Richelme H, Benchimol D, Mouroux J, Bernard JL, Pulcini A.
    Journal: Ann Chir; 1989; 43(1):40-4. PubMed ID: 2930144.
    Abstract:
    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.
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