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Management of delayed intrathoracic esophageal perforation with modified intraluminal esophageal stent
- Source :
- Diseases of the Esophagus. 22:434-438
- Publication Year :
- 2009
- Publisher :
- Oxford University Press (OUP), 2009.
-
Abstract
- SUMMARY In this article, we reviewed our experience of treatment of the delayed intrathoracic nonmalignant esophageal perforation employing modified intraluminal esophageal stent. Between February 1990 and August 2006, eight patients were included in this study. Five patients experienced sepsis. The interval time between perforation and stent placement ranged from 36 h to 27 days (average, 8.6 days). Esophageal stenting and throracotomy for foreign body removal were performed in four patients. The remaining four patients underwent stent placement and thoracostomy. Nutrition was initiated through gastrostomy after 7 to 10 days after the stenting. The stent was removed after the patients resumed oral intake of food and the esophagogram showed that perforation was closed. There was no death in this group. Signs of sepsis remitted 1 week after stent placement. Complications included stress ulcer, stimulative cough, and pneumonia each. Stent removal ranged 32 to 120 days (average 66.7) after its placement. The stent was kept in place for 4 months to prevent formation of esophageal stricture in one patient with caustic esophageal burns. The follow-up was completed in all the patients. The mean follow-up period was 59 months (range 12–180). One patient with caustic esophageal burn underwent cicatricial esophagectomy and gastric transposition 3 years later due to the esophageal stricture. Barium swallow demonstrated that there was a diverticulum-like outpouching in one patient and slight esophageal stricture at T2 and T3 level in another. One patient developed reflux esophagitis 5 years after stent removal. All the patients finally had a normal intake of food. Modified esophageal stenting is an effective method to manage the delayed intrathoracic esophageal perforation. Prevention of stent migration and its convenient adjustment might be the major advantages of this method.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Caustics
medicine.medical_treatment
Perforation (oil well)
Thoracostomy
Esophageal Diseases
Enteral Nutrition
Esophagus
Postoperative Complications
Esophageal stent
Stress, Physiological
Sepsis
Burns, Chemical
medicine
Humans
Reflux esophagitis
Esophagitis, Peptic
Ulcer
Gastrostomy
Esophageal Perforation
business.industry
Gastroenterology
Stent
Pneumonia
General Medicine
Middle Aged
Foreign Bodies
equipment and supplies
medicine.disease
Surgery
Diverticulum
medicine.anatomical_structure
Cough
Thoracotomy
Esophagectomy
Esophageal stricture
Esophageal Stenosis
Female
Stents
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14422050 and 11208694
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Diseases of the Esophagus
- Accession number :
- edsair.doi.dedup.....362625e1392595159ac962480a5b2324