COLON INTERPOSITION FOR PALLIATION OF MALIGNANT ESOPHAGOTRACHEAL FISTULA

A segment of colon has been interposed between the cervical esophagus and stomach in an attempt to give some relief to three patients suffering from the ill effects of a free passage between the esophagus and respiratory tract secondary to malignant degeneration. One patient died of respiratory failure after aspiration of the products of a gastric hemorrhage on the second postoperative day, but the other two patients survived for one and two months, respectively, markedly relieved of their most distressing symptoms. Our limited experience suggests that improved results could be obtained by: (1) early recognition of the condition; (2) proper selection of suitable patients by expeditious application of measures to evaluate the extent of the disease and the patient's reserve; (3) prompt operative intervention, incorporating interposition of colon (descending or ascending) between the cervical esophagus and stomach, ligation of the abdominal esophagus, and temporary catheter gastrostomy. © 1969.