Management of delayed intrathoracic esophageal perforation with modified intraluminal esophageal stent
| Autor: | Tai-Qian Gong, Bo Deng, Yun-Ping Zhao, Jing-Hai Zhou, Yi-Dan Lin, R.-W. Wang, Zheng Ma, Yao-Guang Jiang, Qun-You Tan |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
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 |
| Zdroj: | Diseases of the Esophagus. 22:434-438 |
| ISSN: | 1442-2050 1120-8694 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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