Iatrogenic esophageal injuries

Evidence-based management for diagnosis and timing of contrast studies after repair

Ellen Ko, Albert Yurvati

Research output: Contribution to journalReview articleResearchpeer-review

2 Citations (Scopus)

Abstract

Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor- Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12%) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25%), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalInternational Surgery
Volume97
Issue number1
DOIs
StatePublished - 1 Jan 2012

Fingerprint

Wounds and Injuries
Mediastinitis
Mortality
Debridement
Hospital Mortality
Esophagus
Length of Stay
Thorax
Morbidity
Surgeons

Keywords

  • Esophagus
  • Esophogram
  • Perforation

Cite this

@article{1e54ce4a4a80466985064002f51d4832,
title = "Iatrogenic esophageal injuries: Evidence-based management for diagnosis and timing of contrast studies after repair",
abstract = "Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor- Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12{\%}) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25{\%}), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.",
keywords = "Esophagus, Esophogram, Perforation",
author = "Ellen Ko and Albert Yurvati",
year = "2012",
month = "1",
day = "1",
doi = "10.9738/CC73.1",
language = "English",
volume = "97",
pages = "1--5",
journal = "International Surgery",
issn = "0020-8868",
publisher = "International College of Surgeons",
number = "1",

}

Iatrogenic esophageal injuries : Evidence-based management for diagnosis and timing of contrast studies after repair. / Ko, Ellen; Yurvati, Albert.

In: International Surgery, Vol. 97, No. 1, 01.01.2012, p. 1-5.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Iatrogenic esophageal injuries

T2 - Evidence-based management for diagnosis and timing of contrast studies after repair

AU - Ko, Ellen

AU - Yurvati, Albert

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor- Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12%) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25%), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.

AB - Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor- Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12%) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25%), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.

KW - Esophagus

KW - Esophogram

KW - Perforation

UR - http://www.scopus.com/inward/record.url?scp=84871242098&partnerID=8YFLogxK

U2 - 10.9738/CC73.1

DO - 10.9738/CC73.1

M3 - Review article

VL - 97

SP - 1

EP - 5

JO - International Surgery

JF - International Surgery

SN - 0020-8868

IS - 1

ER -