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Liao F, Yang Q, Zhan Z, Zhu Z, Pan X, Wang C, Li B, Zhu Y, Chen Y, Shu X. Routine nasogastric tube placement in patients with small esophageal perforation after endoscopic foreign body removal may be unnecessary: a propensity score matching analysis. Gastroenterol Rep (Oxf) 2023; 11:goad044. [PMID: 37521332 PMCID: PMC10386876 DOI: 10.1093/gastro/goad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/25/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Nasogastric tube (NGT) placement is part of the post-operative management of upper gastrointestinal perforation, but its routine use in esophageal perforation (EP) caused by foreign bodies remains unclear. The purpose of this research was to investigate the necessity for routine NGT placement in patients with EP after endoscopic foreign body removal. Methods A total of 323 patients diagnosed with EP caused by foreign bodies at the First Affiliated Hospital of Nanchang University between January 2012 and December 2021 were included in this retrospective study. Patients were divided into the NGT group and the non-NGT group according to whether or not NGT placement was performed. The perforation healing rate, post-operative adverse events, hospital stay, and death rate were analysed using a 1:1 propensity score matching model. Results Before matching, there were 263 patients in the NGT group and 60 patients in the non-NGT group. There were significant differences in the time to treatment, infection, albumin, and types of endoscopy between the two groups, while the length of hospital stay in the NGT group was significantly longer than that in the non-NGT group. After 1:1 propensity score matching, 48 pairs of patients were matched between the two groups. The perforation healing rate, post-operative adverse events, length of hospital stay, and death rate did not show significant differences between the two groups. Conclusions For patients with small EP caused by foreign bodies, routine NGT placement after endoscopic foreign body removal may be unnecessary.
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Affiliation(s)
| | | | | | - Zhenhua Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
- Jiangxi Clinical Research Center for Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Xiaolin Pan
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Chong Wang
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Bimin Li
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Yin Zhu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Youxiang Chen
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P. R. China
| | - Xu Shu
- Corresponding author. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, Jiangxi 330006, P. R. China. Tel: +86-791-88692505; Fax: +86-791-88623153;
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Chirica M, Bonavina L. Esophageal emergencies. Minerva Surg 2023; 78:52-67. [PMID: 36511315 DOI: 10.23736/s2724-5691.22.09781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The esophagus is a deeply located organ which traverses the neck, the thorax, and the abdomen and is surrounded at each level by vital organs. Because of its positioning injuries to the esophagus are rare. Their common denominator is the risk of the organ perforation leading to spillage of digestive contents in surrounding spaces, severe sepsis and eventually death. Most frequent esophageal emergencies are related to the ingestion of foreign bodies or caustic agents, to iatrogenic or spontaneous esophageal perforation and external esophageal trauma. Early diagnosis and appropriate management are the keys of successful outcomes.
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Affiliation(s)
- Mircea Chirica
- Department of Digestive Surgery, Grenoble Alpes University Hospital, Grenoble, France -
| | - Luigi Bonavina
- Medical School, Division of General Surgery, IRCCS San Donato Polyclinic, University of Milan, Milan, Italy
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3
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Cerasoli B, Piro N, Mandelli C, Cesari M. Conservative management and healing of oesophageal perforation in a frail old woman. Age Ageing 2021; 50:265-266. [PMID: 32902607 DOI: 10.1093/ageing/afaa170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/07/2020] [Accepted: 06/23/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Benedetta Cerasoli
- Specialisation School in Geriatrics and Gerontology, University of Milan, Milan, Italy
| | - Niccolò Piro
- Specialisation School in Geriatrics and Gerontology, University of Milan, Milan, Italy
| | - Clara Mandelli
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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4
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Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva CG, Asti E, Ferrari D, Leppäniemi A, Ten Broek RPG, Brichon PY, Kluger Y, Fraga GP, Frey G, Andreollo NA, Coccolini F, Frattini C, Moore EE, Chiara O, Di Saverio S, Sartelli M, Weber D, Ansaloni L, Biffl W, Corte H, Wani I, Baiocchi G, Cattan P, Catena F, Bonavina L. Esophageal emergencies: WSES guidelines. World J Emerg Surg 2019; 14:26. [PMID: 31164915 PMCID: PMC6544956 DOI: 10.1186/s13017-019-0245-2] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/20/2019] [Indexed: 02/06/2023] Open
Abstract
The esophagus traverses three body compartments (neck, thorax, and abdomen) and is surrounded at each level by vital organs. Injuries to the esophagus may be classified as foreign body ingestion, caustic ingestion, esophageal perforation, and esophageal trauma. These lesions can be life-threatening either by digestive contamination of surrounding structures in case of esophageal wall breach or concomitant damage of surrounding organs. Early diagnosis and timely therapeutic intervention are the keys of successful management.
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Affiliation(s)
- Mircea Chirica
- 1Department of Digestive Surgery, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Michael D Kelly
- Department of General Surgery, Albury Hospital, Albury, NSW 2640 Australia
| | - Stefano Siboni
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
| | - Alberto Aiolfi
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
| | - Carlo Galdino Riva
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
| | - Emanuele Asti
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
| | - Davide Ferrari
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
| | - Ari Leppäniemi
- Department of Emergency Surgery, University Hospital Meilahti Abdominal Center, Helsinki, Finland
| | - Richard P G Ten Broek
- 5Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pierre Yves Brichon
- 6Department of Thoracic Surgery, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Yoram Kluger
- 7Department of General Surgery, Rambam Health Campus, Haifa, Israel
| | - Gustavo Pereira Fraga
- 8Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP Brazil
| | - Gil Frey
- 6Department of Thoracic Surgery, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Nelson Adami Andreollo
- 8Division of Trauma Surgery, School of Medical Sciences, University of Campinas, Campinas, SP Brazil
| | - Federico Coccolini
- 9General, Emergency and Trauma Surgery Department, Bufalini Hospital Cesena, Cesena, Italy
| | | | | | - Osvaldo Chiara
- 12General Surgery and Trauma Team, University of Milano, ASST Niguarda Milano, Milan, Italy
| | - Salomone Di Saverio
- 13Cambridge Colorectal Unit, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
| | | | - Dieter Weber
- 15Trauma and General Surgery, Royal Perth Hospital, Perth, Australia
| | - Luca Ansaloni
- 9General, Emergency and Trauma Surgery Department, Bufalini Hospital Cesena, Cesena, Italy
| | - Walter Biffl
- 16Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital, La Jolla, CA USA
| | - Helene Corte
- 17Department of Surgery, Saint Louis Hospital, Paris, France
| | - Imtaz Wani
- 18Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Pierre Cattan
- 17Department of Surgery, Saint Louis Hospital, Paris, France
| | - Fausto Catena
- 20Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Luigi Bonavina
- 3Division of General Surgery, IRCCS Policlinico San Donato, University of Milan Medical School, Milan, Italy
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