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Outcome after iatrogenic esophageal perforation.
Tobias Hauge1, Ole Christian Kleven2, Egil Johnson3,4
1a Department of Surgery , Drammen Hospital, Vestre Viken HF , Drammen , Norway.
Scandinavian Journal of Gastroenterology
|March 13, 2019
Summary
Iatrogenic esophageal perforations can be effectively managed non-surgically, showing low mortality and good healing rates. However, long-term outcomes reveal reduced quality of life despite comparable dysphagia and fatigue levels to the general population.
Area of Science:
- Gastroenterology
- Esophageal Surgery
- Medical Device Technology
Background:
- Iatrogenic esophageal perforations are the most frequent cause of esophageal perforation.
- Esophageal perforations pose significant risks, necessitating effective management strategies.
Purpose of the Study:
- To evaluate the outcomes of a primarily non-operative treatment approach for iatrogenic esophageal perforations.
- To assess the long-term quality of life, dysphagia, and fatigue in patients treated for iatrogenic esophageal perforations.
Main Methods:
- A retrospective review of 21 patients treated for iatrogenic esophageal perforation between 2007 and 2014.
- Patients were followed for a median of 82 months, with assessment of dysphagia, health-related quality of life (HRQoL), and fatigue via questionnaires.
- Treatment strategies included non-surgical management (71.4%) and surgical intervention (28.6%), with a high rate of esophageal stent placement (66.7%).
Main Results:
- The median in-hospital stay was 10.5 days, with a mortality rate of 4.8%.
- Esophageal perforations healed within a median of 2.5 months.
- Long-term follow-up indicated reduced HRQoL, while dysphagia and fatigue levels were comparable to a reference population.
Conclusions:
- Non-operative management of iatrogenic esophageal perforations yields satisfactory short-term and long-term results with low mortality.
- While esophageal perforations heal effectively, patients experience a long-term reduction in health-related quality of life.
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