Duranceau A, Jamieson G G
Ann Thorac Surg. 1984 Apr;37(4):346-54. doi: 10.1016/s0003-4975(10)60745-x.
Malignant tracheoesophageal fistula occurs infrequently in patients with esophageal and lung cancer. However, the occurrence of this entity is very distressing for the patient since it leads to rapid deterioration and death due to overwhelming pulmonary infection. A review of cases reported in the recent world literature is presented. The only effective treatment is to exclude the fistula from the alimentary tract. This may be achieved by intubation or operation. Intubation is probably associated with a lower mortality but is less certain to control the fistula. Single-stage operative exclusion and bypass is preferred under ideal circumstances. However, the patient's condition may dictate that a two-stage operation be performed--first, operative exclusion of the fistula and then, if the patient's respiratory and nutritional state improves sufficiently, restoration of alimentary continuity at a later date.
恶性气管食管瘘在食管癌和肺癌患者中并不常见。然而，这种情况的发生对患者来说非常痛苦，因为它会导致因严重肺部感染而迅速恶化和死亡。本文对近期世界文献报道的病例进行了综述。唯一有效的治疗方法是将瘘管与消化道隔离。这可以通过插管或手术来实现。插管可能死亡率较低，但控制瘘管的效果不太确定。在理想情况下，首选一期手术隔离和旁路手术。然而，患者的病情可能决定进行二期手术——首先手术隔离瘘管，然后，如果患者的呼吸和营养状况充分改善，在以后恢复消化道的连续性。
