Expandable stents for iatrogenic perforation of esophageal malignancies

Russell E. White, Caesar Mungatana, Mark Topazian, Robert V Rege

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

The management of patients with iatrogenic perforation of esophageal cancers is controversial. We reviewed the management of perforated esophageal malignancies at a single institution with a large volume of patients with esophageal cancer. Cases of iatrogenic perforation of the esophagus occurring during a 3-year period were identified from the hospital endoscopy database. Inpatient and outpatient records were reviewed, and subjects were visited to obtain follow-up information. Perforation was suspected after 10 of 492 endoscopic dilatation procedures done in patients with obstructing esophageal malignancies. All patients were diagnosed immediately. One patient with pneumomediastinum and pneumoperitoneum died 7 days after laparotomy. Nine patients with pneumomediastinum were managed endoscopically with delayed (n = 1) or immediate (n = 8) placement of a self-expanding metal stent. Patients were treated in the hospital for an average of 5.4 days. No patients developed clinical signs of sepsis, and all were discharged tolerating a soft diet. Follow-up data were obtained for seven of nine discharged patients (range 152 to 263 days). None developed signs or symptoms of infection or recurrent dysphagia. Immediate placement of a coated self-expanding metal stent is an effective treatment for iatrogenic perforation of an obstructing esophageal malignancy.

Original languageEnglish (US)
Pages (from-to)715-719
Number of pages5
JournalJournal of Gastrointestinal Surgery
Volume7
Issue number6
DOIs
StatePublished - Jan 1 2003

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Keywords

  • Dilatation
  • Esophageal neoplasms
  • Esophageal perforation
  • Stents

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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