The management of patients with iatrogenic perforation of esophageal cancers is controversial.
In this study, doctors reviewed the management of perforated esophageal malignancies in patients with esophageal cancer.
The team identified cases of iatrogenic perforation of the esophagus which occurred over a 3-year period.
They evaluated both inpatient and outpatient records, and patients were visited to obtain follow-up information.
The researchers found that perforation was suspected after 10 of 492 endoscopic dilatation procedures.
|Perforation was suspected after 10 of 492 endoscopic dilatation procedures.|
|Journal of Gastrointestinal Surgery|
Of the 10 patients, 1 patient with pneumomediastinum and pneumoperitoneum died 7 days after laparotomy.
The remaining 9 patients with pneumomediastinum were managed endoscopically with the placement of a self-expanding metal stent. These patients remained in the hospital for an average of 5.4 days.
The team found that none of the patients developed sepsis, and all were discharged tolerating a soft diet. None developed signs or symptoms of infection or recurrent dysphagia during follow-up.
Dr Russell White's team concluded, "Immediate placement of a coated self-expanding metal stent is an effective treatment for iatrogenic perforation of an obstructing esophageal malignancy".