Actualización en el manejo endoscópico de las fístulas traqueoesofágicas: ¿Qué debemos considerar?
DOI:
https://doi.org/10.30944/20117582.3024Palabras clave:
fístula traqueoesofágica, endoscopia, manejo de la enfermedad, cuidados paliativos, bioprótesisResumen
Introducción. Las fístulas traqueoesofágicas constituyen una complicación de alto impacto clínico, que compromete gravemente la función respiratoria, el estado nutricional y la calidad de vida.
Métodos. Se realizó una revisión narrativa mediante búsqueda sistemática en bases de datos biomédicas (MEDLINE, EMBASE, Cochrane Library, OVID y ClinicalKey), sin restricciones de idioma ni temporalidad, empleando descriptores controlados en ciencias de la salud.
Resultados. Se identificaron diversas intervenciones, como el uso de prótesis esofágicas, traqueales o combinadas, matrices biológicas, técnicas de sutura endoscópica, clipado y dispositivos oclusores extrapolados. En las fístulas benignas, el tratamiento quirúrgico sigue siendo el estándar, mientras que en las fístulas de causa neoplásica maligna el abordaje endoscópico se ha consolidado como alternativa principal. Si bien se documentan mejoras clínicas relevantes, persisten limitaciones técnicas, riesgo de complicaciones y escasa evidencia comparativa.
Conclusiones. El manejo endoscópico representa una opción terapéutica útil, tanto en escenarios benignos B seleccionados como en contextos malignos avanzados. Se requieren estudios prospectivos que permitan establecer algoritmos estandarizados basados en la localización, tamaño y etiología de la fístula.
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