Chang Yung-Hung, Chien Chih-Ying, Chen Chih-Chi, Fu Chih-Yuan, Hsieh Chi-Hsun, Liao Chien-Hung
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
Chang Gung University, Taoyuan, Taiwan.
World J Surg. 2018 Jul;42(7):2028-2035. doi: 10.1007/s00268-017-4451-3.
Corrosive ingestion results in necrosis of the digestive tract, spillage of intraluminal fluid, and spread of bacteria that threatens the lives of patients. Some authors advise extensive surgery, although others recommend conservative operation. This study presents the outcomes of the patients of corrosive injury who undergo emergent surgery.
We conducted a retrospective review including patients with corrosive injury from Jan 2007 to Dec 2013. We retrieved and analyzed the demographic characteristics, injury location and extent, endoscopic grade, presence of surgery, surgical timing and procedure, and mortality.
The cohort consisted of 112 patients; 23 of the patients underwent an emergent operation. Patients who needed emergent surgery had the worse endoscopic severity and a higher mortality rate of 47.8% (12/23). Perforation of the digestive tract [odds ratio (OR) 13.5, p = 0.011] and unscheduled reoperation (OR 13.2, p = 0.033) were factors that predict mortality.
Corrosive injury resulted in a dismal prognosis, especially when patients required an operation. The mortality is related to digestive tract perforation and unscheduled reoperation. Inadequate resection might lead to unscheduled reoperations, which lead to a dismal prognosis.
腐蚀性物质摄入会导致消化道坏死、管腔内液体外溢以及细菌扩散，危及患者生命。一些作者建议进行广泛手术，而另一些人则推荐保守手术。本研究展示了接受急诊手术的腐蚀性损伤患者的治疗结果。
我们进行了一项回顾性研究，纳入了2007年1月至2013年12月期间的腐蚀性损伤患者。我们收集并分析了患者的人口统计学特征、损伤部位和范围、内镜分级、是否进行手术、手术时机和手术方式以及死亡率。
该队列包括112例患者；其中23例患者接受了急诊手术。需要急诊手术的患者内镜严重程度更差，死亡率更高，为47.8%（12/23）。消化道穿孔（比值比[OR] 13.5，p = 0.011）和非计划再次手术（OR 13.2，p = 0.033）是预测死亡率的因素。
腐蚀性损伤导致预后不良，尤其是当患者需要手术时。死亡率与消化道穿孔和非计划再次手术有关。切除不充分可能导致非计划再次手术，进而导致预后不良。
