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Esophageal stenting in caustic injuries: a modified technique to avoid laparotomy

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Abstract

Objective

To compare the outcomes of a modified laparoscopic intraluminal stenting with the conventional laparatomic technique in patients with esophageal caustic injuries.

Methods

A total of 103 patients with esophageal burns were included in this retrospective analysis. Patients were candidates for esophageal stenting to prevent future stenosis. According to patient preference, stenting was done with either the innovatory stent with the modified technique (52 patients) or the conventional method that required laparotomy (51 patients). The modified technique consists of placing an inflation balloon stent via laparoscopy. Overall mortality and complications after follow-up period (3 months) were compared between the two groups.

Results

Two perioperative mortalities were seen, one in each group. Except one patient in the modified technique, all patients returned to normal intake after 3 months of follow-up. However, five patients of the modified group and three in the conventional group developed esophageal strictures (p > 0.05). Gastric outlet obstruction was observed in three patients of the modified group and one in the conventional group (p > 0.05). DeMeester scores showed that there was no gastro-esophageal reflux in both groups (p > 0.05).

Conclusion

Our results show that the modified technique can reach the efficacy of the conventional method without requiring laparotomy. Thus, far several studies have demonstrated the advantages of laparoscopy over laparotomy. Thus, and in line with the clinical guidelines of the Society of American Gastrointestinal and Endoscopic Surgeons, we recommend using the presented modified technique in patients with caustic esophageal injuries.

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Authors and Affiliations

  1. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Ali Sina Shahi, Behnoosh Behdad, Alireza Esmaeili, Mojtaba Moztarzadeh & Hassan Peyvandi

  2. Surgery Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, South Kargar Street, Makhsoos Street, Tehran, Iran

    Hassan Peyvandi

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  1. Ali Sina Shahi
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  2. Behnoosh Behdad
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  3. Alireza Esmaeili
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  4. Mojtaba Moztarzadeh
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  5. Hassan Peyvandi
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Correspondence to Hassan Peyvandi.

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Shahi, A., Behdad, B., Esmaeili, A. et al. Esophageal stenting in caustic injuries: a modified technique to avoid laparotomy. Gen Thorac Cardiovasc Surg 63, 406–412 (2015). https://doi.org/10.1007/s11748-015-0558-3

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  • DOI: https://doi.org/10.1007/s11748-015-0558-3

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