Background: Iatrogenic esophageal perforation accounts 60% of esophageal perforations and associated with 19% of mortality. Endoscopic procedures & invasive surgical maneuvers are the common causes. Pain, dysphagia and subcutaneous emphysema are common manifestations. Water soluble contrast study, CT scan, and endoscopy provide a high sensitivity for diagnosis. Early aggressive management within the first 24 hours is crucial for excellent outcomes; majority of patients is suitable for non-operative management while surgical intervention and esophageal stenting are alternative treatment options. Aim of the work: To compare efficacy of different management modalities in patients with iatrogenic esophageal perforations. Patient and Methods: Papers provided data from March 2007 to June 2022 related to patients with iatrogenic esophageal perforation & comparing different management modalities are reviewed between January 2021 and June 2022. We made pairwise meta-analyses of our outcomes using Comprehensive Meta-Analysis software (CMA version 3.9). Event rate with the corresponding 95% confidence intervals (95%CI) was also being calculated for categorical data. Results: In majority of patients non-operative management is the best option with successful rate of more than 90% and lowest mortality (6.3%). Surgical management is warranted in the patients who do not meet the criteria for conservative treatment with successful rate of more than 80%. Esophageal stent is an alternative treatment option with 50 to 83% of esophageal healing. Conclusions: The treatment method still has to be chosen on an individual basis. We recommend conservative treatment when indicated. Extended perforations should be treated with a surgical approach and esophageal stenting have a satisfactory outcome in suitable patients.
Omar Siad Nur, H., Mahfouz M. Omar, M., Mahmoud El Hefny, A. M., Alsayed Hamed, M. A., & el-din Abdalla Ali., A. H. (2022). COMPARATIVE STUDY BETWEEN DIFFERENT MANAGEMENT MODALITIES OF IATROGENIC ESOPHAGEAL PERFORATIONS. Ain Shams Medical Journal, 73(3), 613-624. doi: 10.21608/asmj.2022.270237
MLA
Hassan Omar Siad Nur; Mohamed Mahfouz M. Omar; Amr Mohamed Mahmoud El Hefny; Mohammed Abdalmageed Alsayed Hamed; Ayman Hussam el-din Abdalla Ali.. "COMPARATIVE STUDY BETWEEN DIFFERENT MANAGEMENT MODALITIES OF IATROGENIC ESOPHAGEAL PERFORATIONS", Ain Shams Medical Journal, 73, 3, 2022, 613-624. doi: 10.21608/asmj.2022.270237
HARVARD
Omar Siad Nur, H., Mahfouz M. Omar, M., Mahmoud El Hefny, A. M., Alsayed Hamed, M. A., el-din Abdalla Ali., A. H. (2022). 'COMPARATIVE STUDY BETWEEN DIFFERENT MANAGEMENT MODALITIES OF IATROGENIC ESOPHAGEAL PERFORATIONS', Ain Shams Medical Journal, 73(3), pp. 613-624. doi: 10.21608/asmj.2022.270237
VANCOUVER
Omar Siad Nur, H., Mahfouz M. Omar, M., Mahmoud El Hefny, A. M., Alsayed Hamed, M. A., el-din Abdalla Ali., A. H. COMPARATIVE STUDY BETWEEN DIFFERENT MANAGEMENT MODALITIES OF IATROGENIC ESOPHAGEAL PERFORATIONS. Ain Shams Medical Journal, 2022; 73(3): 613-624. doi: 10.21608/asmj.2022.270237
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