Expandable stents for iatrogenic perforation of esophageal malignancies

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

Research output: Contribution to journalArticle

28 Citations (Scopus)

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)715-720
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume7
Issue number6
DOIs
StatePublished - Sep 2003

Fingerprint

Esophageal Perforation
Stents
Neoplasms
Mediastinal Emphysema
Esophageal Neoplasms
Metals
Pneumoperitoneum
Deglutition Disorders
Laparotomy
Esophagus
Endoscopy
Signs and Symptoms
Inpatients
Dilatation
Sepsis
Outpatients
Databases
Diet

Keywords

  • Dilatation
  • Esophageal neoplasms
  • Esophageal perforation
  • Stents

ASJC Scopus subject areas

  • Surgery

Cite this

Expandable stents for iatrogenic perforation of esophageal malignancies. / White, Russell E.; Mungatana, Caesar; Topazian, Mark; Rege, Robert V.

In: Journal of Gastrointestinal Surgery, Vol. 7, No. 6, 09.2003, p. 715-720.

Research output: Contribution to journalArticle

White, Russell E. ; Mungatana, Caesar ; Topazian, Mark ; Rege, Robert V. / Expandable stents for iatrogenic perforation of esophageal malignancies. In: Journal of Gastrointestinal Surgery. 2003 ; Vol. 7, No. 6. pp. 715-720.
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