Surgical Management of Impacted Dentures in the Oesophagus—A 10-year experience from an Upper Gastrointestinal Surgical Unit.

Oesophageal denture impactions may have varying presentations ranging from dysphagia to a complex tracheo-oesophageal fistula (TOF). Endoscopic removal of the denture may be unsuccessful due to the sharp-edged nature of the denture with metal appendages and delayed presentation. In such instances, surgical treatment may be the safer option. We aim to study the different presentations of impacted dentures in the oesophagus requiring operative intervention and the best surgical approach in these patients. This is a case series analysis of our experience in the surgical management of patients with impacted oesophageal dentures, presenting to our Upper Gastrointestinal Surgical Unit, over a 10-year period from 2009 to 2019. A total of 15 patients (M: F—8:7) with ages ranging from 25 to 67 years underwent surgical removal of impacted dentures during the time period. Dysphagia was the commonest presenting symptom, and the site of impaction was equally common in both cervical and thoracic oesophagus. Cervical impactions were managed by a neck exploration and the thoracic impactions necessitated an open or minimally invasive transthoracic extraction. Three patients with thoracic impactions presented late with tracheo-oesophageal fistula formation. A novel technique (neo-membranous oesophageal patch—NMOP) was used in the management of TOF in these patients. Surgical management of impacted oesophageal dentures is required in cases of failed endoscopic retrieval. The surgical management should involve an algorithmic approach based on the site of impaction, associated local sepsis, and the presence or absence of a fistula. Tracheo-oesophageal fistula is a rare complication of impacted dentures and we have successfully used a novel technique (NMOP) for the management of this difficult problem. [ABSTRACT FROM AUTHOR]