Corrosive Injury of the Upper Gastrointestinal Tract: Review of Surgical Management and Outcome in 14 Adult Cases | ||
| Iranian Journal of Otorhinolaryngology | ||
| مقاله 3، دوره 27، شماره 1، فروردین 2015، صفحه 15-21 اصل مقاله (223.33 K) | ||
| نوع مقاله: Original | ||
| شناسه دیجیتال (DOI): 10.22038/ijorl.2015.3419 | ||
| نویسندگان | ||
| Mohammad Taghi Rajabi1؛ Ghodratollah Maddah* 2؛ Reza Bagheri2؛ Mostafa Mehrabi3؛ Hossein Shabahang1؛ Farjad Lorestani1 | ||
| 1Endoscopic & Minimally Invasive Surgery Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. | ||
| 2Cardio- Thoracic Surgery & Transplant Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. | ||
| 3Surgical Oncology Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. | ||
| چکیده | ||
| Introduction: Caustic ingestion is responsible for a spectrum of upper gastrointestinal tract injury from self-limited to perforation. This study conducted to evaluate clinical characteristics as well as surgical outcomes in patients with caustic ingestion. Materials and Methods: Between Nov1993 to march 2011, 14 adults with a clinical evidence of corrosive ingestion were admitted into our institutions (Omid and Ghaem hospitals). Patients evaluated for etiology of erosion, location, type of surgery, morbidity and mortality after surgery. Results: 14 patients (10men and 4 women) with a age range between18-53 years were evaluated. In 6 patients, the injury was accidental and in 8 patients ingestion was a suicide attempt. Ingested agent included nitric acid in 4 patients, hydrochloric acid in 7 patients, sulfuric acid in 2 patients and strong alkali in one patient. The location and extent of lesion varied included esophagus in 13 cases, stomach in 7 cases and the pharynx in 3 cases. Acute abdomen was developed In 2 patients and a procedure of total gasterectomy and blunt esophagectomy was performed. In the remaining patients, substernal esophageal bypass in 2 patients, esophageal resection and replacement surgery in 9 patients and gastroenterostomy in one patient performed to relieve esophageal stricture. Two patients died of mediastinitis after esophageal replacement surgery. Postoperative strictures were developed in 2 survived patients with hypopharyngeal reconstruction that was managed by per oral bougienage in one patient and KTP Laser and stenting in the other patient. Conclusion: Esophageal resection with replacement was safe and good technique for severe corrosive esophageal stricture with low mortality and morbidity. | ||
| کلیدواژهها | ||
| Caustic ingestion؛ Esophageal replacement؛ Esophageal stricture | ||
| مراجع | ||
|
1. Hugh B, Thomas Kelly D. Michael Corrosive ingestion and the surgeon J Am Coll Surg 1999; 189(5): 508-22.
2. Wu Ming-Ho, lai Wu-wei. Esophageal reconstruction for esophageal strictures or resection after corrosive injury. Ann Thoracic Surg 1992; 53(5): 798-802.
3. Browne Y, Dale, Thompson N. James. Caustic ingestion in the book of pediatric otolaryngology head & neck surgery edited by Charles W. Cummings, John M. Fredrickson, Lee A. Richardson, David E. Schuller, 3th edition, volume 5 Mosby-year book Inc 1998: 366-76.
4. Spiegel Joseph R, Sataloff Robert Thayer. Caustic injury of the esophagus in the book of the esophagus edited by D.O. Castell, J. E. Richter 3th ed. Lippincott Williams & Wilkins Philadelphia 1999: 564-77.
5. Thomas Arthur N, Dedo Herbert H, Lim Robert C Jr, Steele Muriel. Pharngoesophageal caustic stricture. Treatment by pharyngogastrostomy compared to colon interposition combined with free bowel graft. Am J Surg 1976; 132(2): 195-203.
6. Doolin Edward J. Composite reconstruction of the Esophagus and hypopharynx after severe caustic injury. Ann Otorhinol Laryngol 1994; 103: 36-40.
7. Panieri E, Rode H, Millar AJW, Cywes S. Oesophageal replacement in the management of corrosive strictures: when is surgery indicated? Pediatr Surg Int 1998; 13: 336-40.
8. Postlethwait RW. Colon interposition for esophageal substitution. Surg, Gynecol & Obstet 1983; 156(3): 377-83.
9. Nicosia Jon F, Thornton Joseph P, Folk Frank A, Saletta John D. Surgical management of corrosive gastric injuries. Annals of Surgery 1974; 180(2): 139-43.
10. Estrera Aaron, Taylor Wayne, Millis Lawrence. J. Corrosive burns of the Esophagus and stomach: A recommendation for an aggressive surgical approach. Annal Thorac Surg 1986; 41(3): 276-83.
11. Jeng Long Bin Benjamin, Chen Hoang-Yang, Chen Shin - Chen, Hwang Tsann-Long, Jan Yi-Yin, Wang Chia-Siu, Chen Miin-Fu. Upper gastrointestinal ablation for patients with extensive injury after ingestion of strong acid. Arch Surg 1994; 129(10): 1086-90.
12. Ashcraft Keith W. Chemicals Esophageal injuries in the book of pediatric surgery edited by Ashcraft, Murphy, Sharp, Sigalet, Synder 3th edition W. B Saunders Company 2000; 325-347.
13. Dilawari JB, Singh Surjit, Rao PN, Anand BS. Corrosive acid ingestion in man-a clinical and endoscopic study. GUT 1984; 25(10): 183-7.
14. Ferguson Mark K, Marcello Migliore, Staszak M. RN, Little Alex.G. Early evaluation and therapy for caustic esophageal injury. Am J Surg 1989; 157(1): 116-20.
15. Peters Jeffrey H, Demeester Tom R. Caustic injury in the principles of surgery edited by Schwartz, Shires, Spencer, Daly, Fischer, Galloway volume ΙΙ 7th edi McGraw-Hill 1999; 1158-61.
16. Ho-Wu Ming, Lai Wu-Wei, Lin Mu-Yen, Chou Nan-Song. Prevention and management of strictures after hypopharyngocolostomy or esophagocolostomy. Ann Thoracic Surgery 1994; 58(1): 108-11.
17. Brun JG, Koskas F, Dubost C. Blunt thorax oesophageal stripping: Am emergency procedure for caustic ingestion. Br J Surg 1984; 71(9): 698-700.
18. Horvath Ors P. Tiborolah, Gabriella Zentai. Emergency Esophagogastrectomy for treatment of hydrochloric acid. Ann Thorac Surg 1991; 52(1): 98-101.
19. Cebeci Hayrettin, Paksoy Melih, Kaytaz Asim, Unal Ethem. Cololaryngostomy procedure in caustic esophageal burns. Eur J Cardio-Thorac Surg 2002; 21(1): 136-9.
20. Howu Ming, Tseng Yau-Lin, Lin Mu-Yen, Lai Wu-Wei. Esophageal reconstruction for hypopharyn- goesophageal strictures after corrosive injury. European J Cardio-Thoracic Surg 2001; 19: 400-5.
21. Ferguson Mark. K. the colon as a reconstructive organ In the book of reconstructive surgery of the esophagus edited by Mark K. Ferguson Futura publishing Company inc. 2002; 161-3.
| ||
|
آمار تعداد مشاهده مقاله: 2,312 تعداد دریافت فایل اصل مقاله: 1,620 |
||