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Management of tracheo-oesophageal fistula in adults

Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiolo...

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Autores principales: Kim, Hyun S., Khemasuwan, Danai, Diaz-Mendoza, Javier, Mehta, Atul C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488631/
https://www.ncbi.nlm.nih.gov/pubmed/33153989
http://dx.doi.org/10.1183/16000617.0094-2020
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author Kim, Hyun S.
Khemasuwan, Danai
Diaz-Mendoza, Javier
Mehta, Atul C.
author_facet Kim, Hyun S.
Khemasuwan, Danai
Diaz-Mendoza, Javier
Mehta, Atul C.
author_sort Kim, Hyun S.
collection PubMed
description Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiologies and acuities, TOF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists and thoracic surgeons alike. Although stents have been a cornerstone in the management of TOF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting procedure both art and science. TOFs relating to underlying oesophageal or tracheal malignancies require advanced understanding of the airway and digestive tract anatomy, dimensions of the fistula, stent characteristics and types, and the interplay between the oesophageal stent and the airway stent if dual stenting procedure is elected. In this review article, we review the most up-to-date data on risk factors, clinical manifestations, diagnostic approaches, management methods and prognosis. Consequently, this article serves to evaluate current therapeutic strategies and the future directions in the areas of 3D-printed stents, over-the-scope clipping systems, tissue matrices and atrial septal closure devices.
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spelling pubmed-94886312022-11-14 Management of tracheo-oesophageal fistula in adults Kim, Hyun S. Khemasuwan, Danai Diaz-Mendoza, Javier Mehta, Atul C. Eur Respir Rev Reviews Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiologies and acuities, TOF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists and thoracic surgeons alike. Although stents have been a cornerstone in the management of TOF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting procedure both art and science. TOFs relating to underlying oesophageal or tracheal malignancies require advanced understanding of the airway and digestive tract anatomy, dimensions of the fistula, stent characteristics and types, and the interplay between the oesophageal stent and the airway stent if dual stenting procedure is elected. In this review article, we review the most up-to-date data on risk factors, clinical manifestations, diagnostic approaches, management methods and prognosis. Consequently, this article serves to evaluate current therapeutic strategies and the future directions in the areas of 3D-printed stents, over-the-scope clipping systems, tissue matrices and atrial septal closure devices. European Respiratory Society 2020-11-04 /pmc/articles/PMC9488631/ /pubmed/33153989 http://dx.doi.org/10.1183/16000617.0094-2020 Text en Copyright ©ERS 2020. https://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Reviews
Kim, Hyun S.
Khemasuwan, Danai
Diaz-Mendoza, Javier
Mehta, Atul C.
Management of tracheo-oesophageal fistula in adults
title Management of tracheo-oesophageal fistula in adults
title_full Management of tracheo-oesophageal fistula in adults
title_fullStr Management of tracheo-oesophageal fistula in adults
title_full_unstemmed Management of tracheo-oesophageal fistula in adults
title_short Management of tracheo-oesophageal fistula in adults
title_sort management of tracheo-oesophageal fistula in adults
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488631/
https://www.ncbi.nlm.nih.gov/pubmed/33153989
http://dx.doi.org/10.1183/16000617.0094-2020
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