Treatment of Malignant Tracheoesophageal Fistula

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.