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Esophageal stenting in caustic injuries: a modified technique to avoid laparotomy
Ali Sina Shahi1, Behnoosh Behdad, Alireza Esmaeili
1School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
General Thoracic and Cardiovascular Surgery
|May 15, 2015
Summary
A modified laparoscopic technique for esophageal stenting in caustic injuries is as effective as the conventional laparotomy method. This minimally invasive approach avoids laparotomy, offering comparable outcomes for patients with esophageal burns.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Esophageal Diseases
Background:
- Caustic esophageal injuries can lead to severe stenosis, necessitating interventions like esophageal stenting.
- Conventional stenting often involves laparotomy, a procedure with significant associated morbidity.
- Minimally invasive techniques are increasingly explored to improve patient outcomes in esophageal surgery.
Purpose of the Study:
- To compare the efficacy and safety of a modified laparoscopic intraluminal stenting technique versus the conventional laparatomic approach for managing esophageal caustic injuries.
- To evaluate outcomes including mortality, complications, and functional recovery after stenting in patients with esophageal burns.
Main Methods:
- A retrospective analysis of 103 patients with esophageal caustic injuries who underwent stenting.
- Patients were divided into two groups: modified laparoscopic intraluminal stenting (52 patients) and conventional laparotomy stenting (51 patients).
- Outcomes such as mortality, esophageal strictures, gastric outlet obstruction, and gastro-esophageal reflux were compared at a 3-month follow-up.
Main Results:
- Two perioperative mortalities occurred, one in each group.
- Functional recovery was similar, with most patients returning to normal intake.
- Complication rates for esophageal strictures and gastric outlet obstruction were not significantly different between the groups (p > 0.05).
- No significant gastro-esophageal reflux was observed in either group based on DeMeester scores (p > 0.05).
Conclusions:
- The modified laparoscopic intraluminal stenting technique achieves comparable efficacy to the conventional laparotomy method for esophageal caustic injuries.
- This minimally invasive approach eliminates the need for laparotomy, aligning with surgical guidelines advocating for laparoscopic procedures.
- The modified technique is recommended for patients with caustic esophageal injuries, offering a less invasive alternative with similar outcomes.
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