Palliation of Malignant Esophago-respiratory Fistulae by Permanent Indwelling Prosthetic Tube

Malignant esophago-respiratory fistula is an incurable condition causing severe distress to those patients suffering from it. Sixty two successive patients with esophago-respiratory fistulae, secondary to squamous cell carcinomas of the esophagus, were intubated for palliation. The first 14 were intubated by a traction technique using the Celestin tube, and the remaining 48 were inbated by the Procter-Livingstone tube inserted by a pulsion method. Celestin intubation had a mortality of 64.3%, but 75% of those intubated by the Procter-Livingstone tube were discharged from hospital, swallowing satisfactorily and relieved of their respiratory distress. In our experience the insertion of the Procter-Livingstone tube by a pulsion technique, can be performed in a few minutes, with little morbidity and allows the patient to be dischaged from hospital within 3–4 days of the procedure. It is a successful and acceptable method of treating malignant esophago-respiratory fistulae.