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Management of corrosive esophageal burns in 149 cases
- Source :
- The Journal of Thoracic and Cardiovascular Surgery. 130(2):449.e1-449.e9
- Publication Year :
- 2005
- Publisher :
- Elsevier BV, 2005.
-
Abstract
- Objectives We sought to present our experience in the management of esophageal burns. Methods From April 1976 through October 2003, 149 patients with corrosive esophageal burns were included in this study. Treatment modalities consisted of modified intraluminal stenting in 28, colon interposition in 71, gastric transposition in 25, repair of cervical stricture with platysma myocutaneous flap in 17, and miscellaneous operations in 12 patients. Eleven of these patients underwent the above procedures twice at our institute. The remaining 7 patients were treated with conservative therapy. Results Twenty-three patients recovered from intraluminal stenting, and 5 experienced stricture after stent removal. One of the 5 patients with failed stents responded to bougienage, and the remaining 4 patients required esophageal reconstruction later. Of the 71 colon interpositions, 5 patients died postoperatively, and complications consisted of proximal anastomotic fistula in 17, anastomotic stenosis in 6, and abdominal incision dehiscence in 2 patients. Postoperative complications in the 25 patients with gastric transpositions comprised anastomotic stricture in 2 patients and empyema in 1 patient. There was a cervical leak in 1 of the 17 patients undergoing the repair of cervical esophageal or anastomotic stricture with a platysma myocutaneous flap. One of the patients in the group undergoing 12 miscellaneous procedures died 8 months after surgical intervention. All the survivors currently eat regular diets. Conclusions Intraluminal stenting can prevent the formation of caustic esophageal stricture. The location of the cicatricial esophagus dictates whether to perform concomitant esophagectomy during esophageal reconstruction. Platysma myocutaneous flap repair is an excellent method for the treatment of severe cervical esophageal or anastomotic stricture.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Adolescent
Caustics
Fistula
medicine.medical_treatment
Dehiscence
Anastomosis
Surgical Flaps
Esophagus
Medicine
Humans
Child
Aged
business.industry
Infant
Middle Aged
medicine.disease
Empyema
Surgery
Stenosis
medicine.anatomical_structure
Treatment Outcome
Esophagectomy
Child, Preschool
Surgical Procedures, Operative
Esophageal stricture
Esophageal Stenosis
Female
Stents
business
Burns
Cardiology and Cardiovascular Medicine
Subjects
Details
- ISSN :
- 00225223
- Volume :
- 130
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- The Journal of Thoracic and Cardiovascular Surgery
- Accession number :
- edsair.doi.dedup.....255ccf5f42726ab53d9c637c1e852a01
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2005.02.029