Authors: Anquan Peng Youzhong Li Zian Xiao Weijing Wu
Publish Date: 2012/03/11
Volume: 269, Issue: 9, Pages: 2027-2036
Abstract
Esophageal foreign bodyinduced esophageal perforation is a lethal complication and its treatment very complex We had reviewed 1428 patients with esophageal foreign body who were hospitalized and treated over the past 25 years A classification summary was made of 121 patients of these 1428 cases who presented with esophageal foreign bodyinduced perforation and complicated cervical abscess mediastinitis and mediastinal abscess This summary considered foreign body types location and lodging duration complications and surgical approaches Among these 121 patients esophageal foreign bodies in 81 patients were successfully extracted via esophagoscope or fiber optic esophagoscope Cervical esophageal foreign bodies in 22 patients were extracted by esophagoscope and lateral cervical incision n = 6 and simple lateral cervical incision n = 16 Thoracotomy was performed to remove thoracic esophageal foreign bodies in 18 patients with 10 successes and 8 failures Of the 121 patients 67 patients with cervical abscess were cured by means of lateral cervical abscess incision and drainage esophageal stent placement and esophageal perforation repair with pedicle myolemma or pedicle muscular periosteum flap 54 patients with mediastinitis and/or abscess were all cured except one mortality by means of mediastinotomy and drainage or/and closedchest drainage simple esophageal repair esophageal repair with pedicle myolemma or pedicle muscular periosteum flap and stent placement for esophageal perforation and esophageal exclusion plus twostage gastricpharyngeal anastomosis In the treatment of esophageal foreign bodyinduced severe complications various therapies should be applied simultaneously Lateral cervical incision should be made immediately to remove the foreign bodies if the foreign body extraction under esophagoscope proves to be a failure after repeated attempts or esophageal perforation develops during the procedure or should cervical abscess develop Mediastinotomy and drainage or/and closedchest drainage should be carried out as early as possible when mediastinitis and/or mediastinal abscess develops after esophageal foreign body ingestion
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