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1.
Anticancer Res ; 39(8): 4399-4403, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366536

RESUMO

BACKGROUND: An esophagorespiratory fistula (ERF) is a fatal complication for patients with tracheobronchial invasion by esophageal cancer. We report the case of a long-term esophageal cancer survivor treated by esophageal bypass operation for ERF after chemoradiotherapy (CRT). CASE REPORT: A 44-year-old man was treated with definitive CRT (i.e. 66 Gy radiotherapy, chemotherapy with cisplatin, and 5-fluorouracil) for unresectable locally advanced esophageal cancer with massive invasion of the left main bronchus. Although a complete clinical response was obtained, the patient developed pneumonia due to an ERF. Esophageal bypass operation was performed for symptomatic relief. The patient's symptoms improved and oral ingestion became possible. No recurrence has been seen for 12 years. CONCLUSION: Esophageal bypass surgery can help in relieving symptoms and might be associated with long-term survival for esophageal cancer patients with ERF after good response to CRT. Thus, bypass surgery is a useful option in the treatment for esophageal cancer with ERF.


Assuntos
Fístula Brônquica/cirurgia , Fístula Esofágica/cirurgia , Neoplasias Esofágicas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Fístula Brônquica/tratamento farmacológico , Fístula Brônquica/patologia , Quimiorradioterapia , Cisplatino/administração & dosagem , Terapia Combinada , Fístula Esofágica/complicações , Fístula Esofágica/patologia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/patologia , Esôfago/patologia , Esôfago/cirurgia , Fluoruracila/administração & dosagem , Humanos , Masculino , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia
2.
Khirurgiia (Mosk) ; (6): 101-106, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317948

RESUMO

Aorto-esophageal and aorto-bronchial fistulas are rare and life-threatening diseases if emergency treatment is absent. The most of publications devoted to this problem are case reports describing successful treatment of patients with aorto-esophageal and aorto-bronchial fistulas by using of endovascular or open transthoracic surgery. However, we did not find reports of several aortic fistulas in a patient after previous aortic stenting. It is presented case report of patient with aorto-esophago-bronchial and aorto-pulmonary fistulas in postoperative period after thoracic endovascular aortic repair (TEVAR).


Assuntos
Aneurisma da Aorta Torácica/cirurgia , Fístula Brônquica/etiologia , Procedimentos Endovasculares/efeitos adversos , Fístula Esofágica/etiologia , Pneumopatias/etiologia , Fístula Vascular/etiologia , Aneurisma da Aorta Torácica/complicações , Doenças da Aorta/etiologia , Doenças da Aorta/cirurgia , Fístula Brônquica/cirurgia , Procedimentos Endovasculares/métodos , Fístula Esofágica/cirurgia , Humanos , Pneumopatias/cirurgia , Fístula do Sistema Respiratório/etiologia , Fístula do Sistema Respiratório/cirurgia , Fístula Vascular/cirurgia
3.
Ann Vasc Surg ; 59: 314.e1-314.e4, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31009726

RESUMO

Secondary stent graft infection is a life-threatening complication after thoracic endovascular aortic repair (TEVAR). There is no consensus on optimal treatment strategy, but combined antibiotic and surgical treatment is advocated. Two years after his TEVAR procedure, a 70-year-old patient was admitted to the hospital with a secondary periaortic abscess. At first, the abscess was managed with clindamycin and transesophageal drainage. The abscess would not dissipate, and an infected iatrogenic aortoesophageal fistula was formed, which was surgically treated with esophageal resection, gastric tube reconstruction, and omental flap coverage.


Assuntos
Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Fístula Esofágica/cirurgia , Esofagectomia , Omento/cirurgia , Infecções Relacionadas à Prótese/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Stents/efeitos adversos , Retalhos Cirúrgicos , Fístula Vascular/cirurgia , Idoso , Antibacterianos/uso terapêutico , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aortografia/métodos , Implante de Prótese Vascular/instrumentação , Angiografia por Tomografia Computadorizada , Drenagem/instrumentação , Procedimentos Endovasculares/instrumentação , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/microbiologia , Humanos , Doença Iatrogênica , Masculino , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/microbiologia , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/microbiologia
4.
J Cardiothorac Surg ; 14(1): 73, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971283

RESUMO

BACKGROUND: Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, incidence of recurrence after the primary repair based on limited data is up to 10% and its treatment is challenging. We report a surgical case of a patient with recurrent acquired benign BEF after primary resection and ensuing successful definitive repair with esophageal bypass surgery after temporary esophageal stenting. CASE REPORT: A 46-year-old male was referred to our department with a symptomatic left-sided bronchoesophageal fistula as a complication of severe acute necrotizing mediastinitis that originated from odontogenic abscess. Previously, several cervicotomies and bilateral thoracotomy were performed at an external medical facility to manage the acute condition. We performed resection of the fistula through re-thoracotomy. Postprocedural esophagography demonstrated a recurrence of bronchoesophageal communication. Postinflammatory adhesions excluded further repair through thoracotomy, therefore a stent was introduced in the esophagus for 12 weeks. Thereafter, an esophageal bypass surgery using a substernaly interposed gastric conduit was performed and resulted in an excellent long-term outcome. CONCLUSIONS: Esophageal bypass surgery using a substernaly interposed gastric conduit may be considered if the standard surgical repair of acquired benign bronchoesophageal fistula is not successful or feasible.


Assuntos
Fístula Brônquica/cirurgia , Fístula Esofágica/cirurgia , Esôfago/cirurgia , Estômago/cirurgia , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/métodos , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/etiologia , Humanos , Masculino , Mediastinite/complicações , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Recidiva , Stents , Toracotomia/efeitos adversos , Aderências Teciduais
5.
Expert Rev Med Devices ; 16(3): 197-209, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30767693

RESUMO

INTRODUCTION: Historically, the gold standard management of esophageal perforations, leaks, and fistulae has been traditional open surgery, but it is associated with significant morbidity and mortality. Minimally invasive approaches offer alternatives to surgery in treating hemodynamically stable patients with such defects. In this review article, we will discuss the recent advancements in the minimally invasive management of esophageal perforations, leaks, and fistulas. AREAS COVERED: This review includes information from case reports, case series, and clinical trials on minimally invasive management of esophageal perforations, leaks, and fistulas. The focus is on the devices, outcomes, and application of the technology. EXPERT COMMENTARY: Minimally invasive treatment represents significant progress in the management of esophageal perforations, leaks, and fistulas. Based on current evidence, it seems safe and effective but it is evolving and more studies are needed to help draw definitive conclusions.


Assuntos
Fístula Esofágica/cirurgia , Perfuração Esofágica/cirurgia , Endoscopia , Perfuração Esofágica/diagnóstico , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Resultado do Tratamento
6.
Ann Thorac Cardiovasc Surg ; 25(2): 82-86, 2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-30541998

RESUMO

Approximately half of the patients with esophageal cancer are diagnosed at an advanced stage with inoperable disease. The technique of bypass surgery, which is one of the palliative procedures for esophageal cancer, usually requires the insertion of a drainage tube for clearing secretions from the blind remnant esophagus. Since the artificial drainage tube is sometimes problematic for the patient after discharge from the hospital, drainage tubeless (DRESS) surgery might be preferable. The authors demonstrated the utility of DRESS bypass surgery by adding esophagostomy in the right supraclavicular region in three patients with unresectable esophageal cancer with and without esophago-respiratory fistula. All patients had been able to take per-orally and discharged the hospital. Two of three patients are alive with per-oral intake at 1 year later. This DRESS bypass surgery technique, which has not hardly reported in the literature, could release the patients from the tube trouble after the discharge from the hospital and give the patients the better quality of life.


Assuntos
Drenagem/métodos , Fístula Esofágica/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagostomia/métodos , Cuidados Paliativos/métodos , Fístula do Sistema Respiratório/cirurgia , Idoso , Idoso de 80 Anos ou mais , Drenagem/efeitos adversos , Ingestão de Alimentos , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Esofagostomia/efeitos adversos , Feminino , Humanos , Masculino , Qualidade de Vida , Fístula do Sistema Respiratório/diagnóstico , Fístula do Sistema Respiratório/etiologia , Resultado do Tratamento
7.
Chirurgia (Bucur) ; 113(2): 202-209, 2018 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29733012

RESUMO

Esophageal surgery has been recognized as very challenging for surgeons and risky for patients. Thoracoscopic approach have proved its benefit in esophageal surgery but has some drawbacks as tremor and limited degrees of freedom, contra-intuitive movements and fulcrum effect of the surgical tools. Robotic technology has been developed with the intent to overcome these limitations of the standard laparoscopy or thoracoscopy. These benefits of robotic procedure are most advantageous when operating in remote areas difficult to reach as in esophageal surgery. AIM: The aim of this paper is to present our small experience related with robotic approach in benign and malignant esophageal tumors and critically revise the evidence available about the use of the robotic technology for the treatment of these pathology. Methods: From January 2008 to September 2016 robotic surgery interventions related with benign or malignant esophageal tumors were performed in "Dan Setlacec" Center for General Surgery and Liver Transplantation of Fundeni Clinical Institute in seven patients. This consisted of dissection of the entire esophagus as part of an abdomino-thoracic-cervical procedure for esophageal cancer in 3 patients and the extirpation of an esophageal leiomyoma in 3 cases and a foregut esophageal cyst in one case. Results: All procedures except one were completed entirely using the da Vinci robotic system. The exception was the first case - a 3 cm leiomyoma of the inferior esophagus with ulceration of the superjacent esophageal mucosa. Pathology reports revealed three esophageal leiomyoma, one foregut cyst and three squamous cell carcinomas with free of tumor resection margins. The mean number of retrieved mediastinal nodes was 24 (22 - 27). The postoperative course was uneventful in four cases, in the other three a esophageal fistula occurred in the converted leiomyoma case (closed in the 14th postoperative day), a prolonged drainage in one esophageal cancer case and a temporary right recurrent nerve palsy in an other one. One patient with esophageal cancer and all patients with benign lesions are alive with no signs of recurrence and no symptomatology. CONCLUSION: Our experience is limited and we cannot conclude for the long term benefits of robotic surgery for esophageal tumors. In our experience the early outcomes were better then using classic open approach, but similar with the cases performed by thoracoscopic approach. We have noticed significant advantages of robotic surgery in relation of lymph node retrieval, leiomyoma dissection safe from esophageal mucosa and suturing. Ergonomics for the surgeon was incomparable better then with the thoracoscopic approach.


Assuntos
Adenocarcinoma/cirurgia , Cisto Esofágico/cirurgia , Fístula Esofágica/etiologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Leiomioma/cirurgia , Procedimentos Cirúrgicos Robóticos/instrumentação , Adenocarcinoma/diagnóstico por imagem , Adulto , Índice de Massa Corporal , Complicações do Diabetes/cirurgia , Cisto Esofágico/diagnóstico por imagem , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/cirurgia , Neoplasias Esofágicas/diagnóstico por imagem , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento
8.
Ann Card Anaesth ; 21(2): 208-211, 2018 Apr-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29652289

RESUMO

A 74-year-old female underwent an uneventful bilateral thoracoscopic maze procedure for persistent atrial fibrillation with continuous transesophageal echocardiographic (TEE) guidance. She presented six weeks later with persistent fever and focal neurological signs. Computed tomography of the thorax revealed air in the posterior LA, raising suspicion for an abscess versus an atrioesophageal fistula (AEF). Before undergoing an exploratory median sternotomy, an esophagogastroduodenoscopy (EGD) was performed by the surgeon to check for any esophageal pathology. This however, resulted in sudden hemodynamic compromise that required intensive treatment with vasopressors and inotropes. In this case-report, we review the various intraoperative risk factors associated with the development of AEF during cardiac ablation procedures as well as the potential hazards of esophageal instrumentation with TEE, naso- or oro- gastric devices, and/or an EGD when an AEF is suspected.


Assuntos
Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Fístula/etiologia , Fístula/cirurgia , Cardiopatias/etiologia , Cardiopatias/cirurgia , Doença Iatrogênica , Cirurgia Torácica Vídeoassistida/métodos , Toracoscopia/métodos , Idoso , Fibrilação Atrial/cirurgia , Ablação por Cateter , Ecocardiografia Transesofagiana , Endoscopia do Sistema Digestório , Fístula Esofágica/diagnóstico por imagem , Evolução Fatal , Feminino , Fístula/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Humanos , Angiografia por Ressonância Magnética , Fatores de Risco , Tomografia Computadorizada por Raios X
9.
Chirurgia (Bucur) ; 113(1): 108-115, 2018 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29509537

RESUMO

Non-malignant esophageal fistulas have a wide spectrum of clinical and pathological features and it`s important to learn to detect and treat them, due to significant morbidity, mortality and costs. The need for minimally invasive, efficient and also quick procedures is imperative. Esophageal stenting using fully-covered expandable stents has become an increasingly preferred option and addresses to fistulas which arise from 2-3 cm beyond Killian's mouth and up to the gastroesophageal junction. The long-term purpose of the procedure is closure of the fistula and thus healing. A second goal would be avoiding the complications generated by long-term wearing of the stent, such as gastrointestinal perforation and stenosis. OBJECTIVES: This review focuses on the efficacy of fully-covered metallic stents in treating benign esophageal fistulas. To this effect, we performed a retrospective study on 21 patients admitted in our clinic between January 2014 and April 2017 for non-malignant esophageal fistulas. The selection criteria were the following: post-operative fistulas (gastric sleeve, fundoplication for transhiatal gastric hernia, even malignancies for which surgical tumor removal was performed), foreign body acquired fistulas, post-traumatic fistulas. Esophago-jejunal anastomotic fistulas were also included in the study (following complete gastrectomy). Results: The efficacy of esophageal stenting was proven in 76% of the cases, resulting in fistula closure. The rest of the patients either didn't achieve fistula closure or couldn't tolerate the stent, calling for early removal of the prosthesis. Reintervention procedures such as stent repositioning or stent replacement (with higher diameter) were carried out in 42% of the cases. A percentage of 19% of the patients who achieved fistula closure developed esophageal stricture on stent-induced ulcers and needed recalibration stenting or esophageal Savary dilation. 22% of the cases needed surgical drainage for infected collections developed simultaneously. We recorded 2 deaths, unrelated to the stenting procedure. Patients who didn't acquire fistula closure were referred to thoracic surgery in good physical condition. Conclusions: Fully-covered metallic esophageal stents can be successfully used to treat benign esophageal fistulas. Follow-up of the patient in order to see if stent repositioning or replacement is needed is crucial. Special design esophageal stents are highly recommended and must not lack. Close cooperation with thoracic surgery is indispensable.


Assuntos
Doenças do Esôfago/terapia , Fístula Esofágica/etiologia , Fístula Esofágica/terapia , Esofagoscopia , Stents Metálicos Autoexpansíveis , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças do Esôfago/complicações , Fístula Esofágica/cirurgia , Esofagoscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Implantação de Prótese , Reoperação , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Stents Metálicos Autoexpansíveis/efeitos adversos , Resultado do Tratamento
10.
Ann Vasc Surg ; 50: 299.e5-299.e7, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29518518

RESUMO

Pseudoaneurysm due to a swallowed fishbone rarely involves subclavian arteries. A 46-year-old male with nonaberrant right subclavian artery (RSA) presented pseudoaneurysm and brachial plexus septic necrosis. Open surgery with sternotomy and right transverse supraclavicular cervicotomy was done in emergency to achieve revascularization using in situ cryopreserved arterial allograft. Infection severity led to septic allograft rupture that necessitated ligation without new arterial reconstruction. During follow-up, patient remained alive 8 months after surgery. Neurological deficit slowly regressed, and no upper arm ischemic sign appeared.


Assuntos
Falso Aneurisma/microbiologia , Aneurisma Infectado/microbiologia , Osso e Ossos , Fístula Esofágica/microbiologia , Migração de Corpo Estranho/etiologia , Alimentos Marinhos , Infecções Estreptocócicas/microbiologia , Artéria Subclávia/microbiologia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/cirurgia , Antibacterianos/uso terapêutico , Angiografia por Tomografia Computadorizada , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/cirurgia , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/cirurgia , Artéria Subclávia/diagnóstico por imagem , Artéria Subclávia/cirurgia , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares
11.
Pediatr Surg Int ; 34(1): 63-69, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29124403

RESUMO

PURPOSE: We describe our experience using a modified suture fistula technique for addressing tension in longer gap esophageal atresia (EA). Esophagoesophagopexy (EEP) is the tacking of the proximal and distal ends of esophageal pouches without formal anastomosis. In this retrospective cohort, we review the outcomes of patients with EA after EEP. METHODS: We reviewed the operative reports of EA cases treated at our institution from 1997 to 2016 and identified all patients described as having EEP. RESULTS: Of 129 EA cases, five patients underwent EEP. Formal anastomosis was not done due to patient's instability, prematurity, or long gap. Median birth weight was 1.4 kg (0.6-2.2 kg), and median gestational age at birth was 29 weeks (25-34 weeks). Age at time of EEP ranged 0-5 months. Esophagoesophageal fistula was confirmed in three patients. All three had strictures requiring weekly dilations. One of these patients died. The two surviving patients underwent fundoplication. CONCLUSION: We describe an alternative technique for esophageal anastomosis in patients for whom a standard anastomosis is not possible. EEP can lead to a functional anastomosis through fistulization and avoid the morbidity of multiple thoracotomies and lengthening procedures. Families should be educated on the potential need for dilations and antireflux procedures.


Assuntos
Atresia Esofágica/cirurgia , Esôfago/cirurgia , Estudos de Coortes , Dilatação , Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Feminino , Fundoplicatura , Humanos , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos
14.
Acta Chir Belg ; 118(1): 56-58, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28460565

RESUMO

BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction. Patient represents 2 years of disease-free survival with good functional results. CONCLUSION: The therapy of esophagopleural and bronchopleural fistula is long-term and complicated, requiring a multidisciplinary approach and several basic principles must be adhered to the management including treatment of infection and prevention of sepsis, local treatment of the fistula and pleural empyema, and adequate ventilation and nutritive care.


Assuntos
Fístula Brônquica/cirurgia , Fístula Esofágica/cirurgia , Recidiva Local de Neoplasia/cirurgia , Doenças Pleurais/cirurgia , Pneumonectomia/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Terapia Combinada , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/etiologia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/etiologia , Pneumonectomia/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Reoperação/métodos , Retalhos Cirúrgicos/transplante , Telas Cirúrgicas , Resultado do Tratamento
19.
J Int Med Res ; 46(2): 612-618, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28703631

RESUMO

A 76-year-old woman was admitted to the hospital four times from November 2007 to June 2009. In this complex case, the patient had silicosis complicated by broncholithiasis, oesophagobronchial fistulas, and relapsed tuberculosis. She had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. Barium oesophagography, gastroesophageal endoscopy, and biopsy suggested oesophageal-related chronic inflammation and ulceration, which may have caused the repeated oesophagobronchial fistulas. Bronchoscopy revealed a free broncholithiasis in the left mainstem bronchus. The patient was admitted a fourth time because of silicotuberculosis relapse. After 9 months of antituberculosis treatment, the patient recovered and was still clinically well at the time of this writing.


Assuntos
Antibióticos Antituberculose/uso terapêutico , Fístula Brônquica/diagnóstico por imagem , Fístula Esofágica/diagnóstico por imagem , Litíase/diagnóstico por imagem , Silicotuberculose/diagnóstico por imagem , Idoso , Fístula Brônquica/tratamento farmacológico , Fístula Brônquica/patologia , Fístula Brônquica/cirurgia , Fístula Esofágica/tratamento farmacológico , Fístula Esofágica/patologia , Fístula Esofágica/cirurgia , Esofagoscopia , Feminino , Humanos , Isoniazida/uso terapêutico , Litíase/tratamento farmacológico , Litíase/patologia , Litíase/cirurgia , Pirazinamida/uso terapêutico , Rifampina/análogos & derivados , Rifampina/uso terapêutico , Silicotuberculose/tratamento farmacológico , Silicotuberculose/patologia , Silicotuberculose/cirurgia , Stents , Resultado do Tratamento
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