CAJ | 학술논문

恶性气管食管瘘(MTEF)是恶性肿瘤累及气管或支气管壁及食管而引起的气管、支气管等呼吸道与食管的病理性交通.MTEF的诊断需要食管造影来确定,瘘口的位置和大小往往需要进一步行支气管镜和食管镜检查来确定.MTEF往往预后不良,治疗措施多以姑息症状和改善生活质量为目的.治疗需要根据患者进行个体化选择,包括食管支架置入术、食管旷置和旁路替代、瘘管切除和修补、放疗等手段,可以延长部分患者的生存期,改善生活质量.MTEF不是化放疗的绝对禁忌证,化放疗尽管可能会合并急性毒性反应,但只要能够成功控制瘘口,可使一般情况好、无远处转移的患者获得较长的生存期.
악성기관식관루(MTEF)시악성종류루급기관혹지기관벽급식관이인기적기관、지기관등호흡도여식관적병이성교통.MTEF적진단수요식관조영래학정,루구적위치화대소왕왕수요진일보행지기관경화식관경검사래학정.MTEF왕왕예후불량,치료조시다이고식증상화개선생활질량위목적.치료수요근거환자진행개체화선택,포괄식관지가치입술、식관광치화방로체대、루관절제화수보、방료등수단,가이연장부분환자적생존기,개선생활질량.MTEF불시화방료적절대금기증,화방료진관가능회합병급성독성반응,단지요능구성공공제루구,가사일반정황호、무원처전이적환자획득교장적생존기.
Malignant tracheoesophageal fistula (MTEF) is pathological communication between the respiratory tracts such as the trachea or bronchia and the esophagus because of malignant tumor dissemination through them.Radiography is an important adjunctive technology in the diagnosis of MTEF,and the location and size of fistula often need the further diagnosis of bronchoscopy and esophagoscopy.The patients are often with an unfavourable prognosis once developed MTEF,and are treated usually with the aim of symptom palliation and life quality improvement.The individual treatment includes esophageal stenting,esophageal exclusion and esophagus bypass,fistula exclusion and repair,radiotherapy and others effective therapy according to the patients condition.These therapies will prolong the life span and improve the life quality of patients.MTEF is not absolute contraindication for chemoradiotherapy.Despite its acute toxicity,this concurrent chemoradiothe rapy protocol appears feasible and effective at closing esophageal malignant fistula,especially in patients in a good general condition and without metastasis.