Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
Anticancer Res. 2019 Aug;39(8):4399-4403. doi: 10.21873/anticanres.13610.
An esophagorespiratory fistula (ERF) is a fatal complication for patients with tracheobronchial invasion by esophageal cancer. We report the case of a long-term esophageal cancer survivor treated by esophageal bypass operation for ERF after chemoradiotherapy (CRT).
A 44-year-old man was treated with definitive CRT (i.e. 66 Gy radiotherapy, chemotherapy with cisplatin, and 5-fluorouracil) for unresectable locally advanced esophageal cancer with massive invasion of the left main bronchus. Although a complete clinical response was obtained, the patient developed pneumonia due to an ERF. Esophageal bypass operation was performed for symptomatic relief. The patient's symptoms improved and oral ingestion became possible. No recurrence has been seen for 12 years.
Esophageal bypass surgery can help in relieving symptoms and might be associated with long-term survival for esophageal cancer patients with ERF after good response to CRT. Thus, bypass surgery is a useful option in the treatment for esophageal cancer with ERF.
食管-呼吸道瘘（ERF）是食管癌侵犯气管支气管患者的致命并发症。我们报告了 1 例经化学放疗（CRT）后行食管旁路手术治疗 ERF 的长期食管癌幸存者。
一名 44 岁男性因左主支气管广泛侵犯的不可切除局部晚期食管癌行根治性 CRT（即 66Gy 放疗、顺铂化疗和氟尿嘧啶）治疗。尽管获得了完全的临床缓解，但患者因 ERF 发生肺炎。为缓解症状而行食管旁路手术。患者的症状改善，能够经口摄入。12 年来未见复发。
对于 CRT 反应良好的 ERF 食管癌患者，食管旁路手术有助于缓解症状，并可能与长期生存相关。因此，旁路手术是治疗 ERF 食管癌的一种有效选择。
