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War injuries to the thoracic esophagus
N Ilic1, A Petricevic, Z Mimica
1Thoracic Surgery Department, University Surgical Hospital, Clinical Hospital Split, Croatia.
Summary
War injuries to the thoracic esophagus are rare but serious. Prompt diagnosis and surgical intervention, including gastric interposition or suturing, can lead to satisfactory outcomes despite a 20% mortality rate in this case series.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Esophageal Surgery
Background:
- War injuries to the thoracic esophagus are infrequent but associated with high morbidity and mortality.
- Experience with managing these complex injuries is limited, particularly from recent conflicts.
Purpose of the Study:
- To present the experience of Split University Hospital in treating war-related thoracic esophageal injuries.
- To analyze surgical outcomes and mortality rates in a cohort of patients treated during the 1991-1995 wars.
Main Methods:
- Retrospective analysis of clinical and surgical data.
- Review of 5 patients with thoracic esophageal injuries sustained during wartime.
- Surgical interventions included temporary double-exclusion, gastric interposition, and esophageal suturing with pericardial protection.
Main Results:
- Five patients (0.2% of total injured) sustained thoracic esophageal injuries.
- Surgical management involved varied techniques, with three undergoing gastric interposition and one simple suturing.
- A 20% mortality rate was observed, with one death due to septic complications.
- The overall surgical outcome was considered satisfactory.
Conclusions:
- Effective management of thoracic esophageal war injuries requires prompt transportation and accurate diagnostic methods.
- Adequate surgical treatment is crucial for reducing mortality and complication rates.
- Early intervention and appropriate surgical techniques can improve patient outcomes in high-stress environments.