Digestive Surgery Division, Department of Gastroenterology, Universidade de São Paulo, São Paulo, Brazil.
Digestive Surgery Division, Department of Gastroenterology, Universidade de São Paulo, São Paulo, Brazil.
J Surg Res. 2021 Aug;264:249-259. doi: 10.1016/j.jss.2021.03.009. Epub 2021 Apr 8.
Corrosive ingestion is a significant challenge for healthcare systems. Limited data are available regarding the best treatments, and there remains a lack of consensus about the optimal surgical approach and its outcomes. This study aims to review the current literature and show a single institution's experience regarding the surgical treatment of esophageal stenosis due to corrosive substance ingestion.
A retrospective review that accounted for demographics, psychiatric profiles, surgical procedures, and outcomes was performed. A systematic review of the literature was performed using PubMed.
In total, 27 surgical procedures for esophageal stenosis due to corrosive substance ingestion were performed from 2010 to 2019. Depression and drug abuse were diagnosed in 30% and 22% of the included patients, respectively. Esophagectomies and esophageal bypasses were performed in 13 and 14 patients, respectively. No 30-day mortality was recorded.
Surgical intervention either by esophagectomy or esophageal bypass results in durable relief from dysphagia. However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams.
腐蚀性摄入对医疗保健系统来说是一个重大挑战。关于最佳治疗方法的数据有限,对于最佳手术方法及其结果仍然缺乏共识。本研究旨在回顾现有文献,并展示单一机构在腐蚀性物质摄入引起的食管狭窄的外科治疗方面的经验。
进行了一项回顾性研究,其中包括人口统计学、精神科特征、手术程序和结果。使用 PubMed 进行了系统的文献回顾。
在 2010 年至 2019 年间,共对 27 例腐蚀性物质摄入引起的食管狭窄进行了手术治疗。纳入的患者中分别有 30%和 22%被诊断为抑郁症和药物滥用。分别对 13 例和 14 例患者进行了食管切除术和食管旁路术。未记录到 30 天死亡率。
通过食管切除术或食管旁路术进行外科干预可持久缓解吞咽困难。然而,成功的临床结果取决于高质量的食管和胸外科医生、重症监护医生、心理学家、精神科医生和营养团队的多学科网络。