Surgical management of esophageal stenosis due to ingestion of corrosive substances

J Surg Res. 2021 Aug:264:249-259. doi: 10.1016/j.jss.2021.03.009. Epub 2021 Apr 8.

Abstract

Background: Corrosive ingestion is a significant challenge for healthcare systems. Limited data are available regarding the best treatments, and there remains a lack of consensus about the optimal surgical approach and its outcomes. This study aims to review the current literature and show a single institution's experience regarding the surgical treatment of esophageal stenosis due to corrosive substance ingestion.

Methods: A retrospective review that accounted for demographics, psychiatric profiles, surgical procedures, and outcomes was performed. A systematic review of the literature was performed using PubMed.

Results: In total, 27 surgical procedures for esophageal stenosis due to corrosive substance ingestion were performed from 2010 to 2019. Depression and drug abuse were diagnosed in 30% and 22% of the included patients, respectively. Esophagectomies and esophageal bypasses were performed in 13 and 14 patients, respectively. No 30-day mortality was recorded.

Conclusion: Surgical intervention either by esophagectomy or esophageal bypass results in durable relief from dysphagia. However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams.

Keywords: Caustics; Esophageal diseases; Esophageal stenosis; Esophagectomy; Sodium hydroxide.

Publication types

  • Systematic Review

MeSH terms

  • Behavior Therapy
  • Burns, Chemical / etiology
  • Burns, Chemical / mortality
  • Burns, Chemical / psychology
  • Burns, Chemical / therapy*
  • Caustics / poisoning*
  • Depression / complications
  • Depression / epidemiology
  • Depression / psychology
  • Depression / therapy
  • Esophageal Stenosis / chemically induced
  • Esophageal Stenosis / mortality
  • Esophageal Stenosis / psychology
  • Esophageal Stenosis / therapy*
  • Esophagectomy / statistics & numerical data*
  • Esophagus / pathology
  • Esophagus / surgery
  • Humans
  • Nutritional Support
  • Patient Care Team
  • Risk Factors
  • Self-Injurious Behavior / etiology
  • Self-Injurious Behavior / mortality
  • Self-Injurious Behavior / psychology
  • Self-Injurious Behavior / therapy*
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / etiology
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy
  • Treatment Outcome

Substances

  • Caustics