ABSTRACT
This article addresses the treatment of malignant enterorespiratory fistulas, especially malignant tracheoesophageal fistula (mTEF). mTEF typically occurs after radiochemotherapy for advanced esophageal cancer. Life expectancy is measured in months after successful treatment, and in days to weeks with a persistent fistula. To stop repeated episodes of aspiration and septic pneumonia, single or double stenting of the esophagus and trachea with self-expandable coated stents is the established palliative treatment. The indications, techniques, and pitfalls of esophageal and tracheal stenting are described. Surgical interventions are justified only in very select cases, so this article focuses on interventional rather than surgical treatment.
Subject(s)
Stents , Tracheoesophageal Fistula/therapy , Bronchoscopy , Esophagoscopy , Esophagus/diagnostic imaging , Esophagus/surgery , Humans , Palliative Care , Radiography, Interventional , Trachea/diagnostic imaging , Trachea/surgery , Tracheoesophageal Fistula/diagnosis , Tracheoesophageal Fistula/etiologyABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of transarterial chemoembolization in the care of patients not eligible for liver transplantation. CONCLUSIONS: Prognosis depends on local response, Okuda score, alpha-fetoprotein level, and tumor size and is independent of the presence of portal venous thrombosis.
