Palliation and survival in malignant oesophago-respiratory fistula

Survival in the presence of malignant oesophago-respiratory fistula is usually limited to a few weeks. In this paper we describe our experience with 3 cases treated by retrosternal oesophagogastric bypass with oesophageal exclusion, and review the experience of previous authors using this and other forms of bypass. The results indicate that both survival and quality of life are considerably better with surgical bypass and exclusion than with any other form of treatment. Indeed, the survival times are frequently better than those achieved after palliative resection of oesophageal carcinoma without fistula. Retrosternal oesophagogastric bypass with oesophageal exclusion is recommended as a simple method of bypass for this condition.