Back to Search Start Over

Current aspects in the management of esophageal trauma: a systematic review and proportional meta-analysis.

Authors :
Papaconstantinou, Dimitrios
Kapetanakis, Emmanouil I
Mylonakis, Adam
Davakis, Spyridon
Kotidis, Efstathios
Tagkalos, Evangelos
Rouvelas, Ioannis
Schizas, Dimitrios
Source :
Diseases of the Esophagus; Jun2024, Vol. 37 Issue 6, p1-11, 11p
Publication Year :
2024

Abstract

Trauma-related esophageal injuries (TEIs) are a rare but highly lethal condition. The presentation of TEIs is very diverse depending on the location and mechanism of injury (blunt vs. penetrating), as well as the presence or absence of concurrent injuries. The aim of the present systematic review and meta-analysis is to delineate the clinical features impacting TEI management. A systematic review of the Medline, Embase, and web of science databases was undertaken for studies reporting on patients with TEIs. A random effects model was employed in the meta-analysis of aggregated data. Eleven studies, incorporating 4605 patients, were included, with a pooled mortality rate of 19% (95% confidence interval (CI) 13–25%). Penetrating injuries were 34% more likely to occur (RR 0.66, 95% CI 0.49–0.89, P  = 0.01), predominantly in the neck compartment. Surgery was employed in 53% of cases (95% CI 32–73%), with 68% of patients having associated injuries (95% CI 43–94%). In terms of choice of surgical repair technique, primary suture repair was most frequently reported, irrespective of injury location. Postoperative drainage was employed in 27% of the cases and was more common following repair of thoracic esophageal injuries. The estimated dependence on mechanical ventilation was 5.91 days (95% CI 5.1–6.72 days), while the length of stay in the intensive care unit averaged 7.89 days (95% CI 7.14–8.65 days). TEIs are uncommon injuries in trauma patients, associated with considerable mortality and morbidity. Open suture repair of ensuing esophageal defects is by large the most employed approach, while stenting may be indicated in carefully selected cases. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
11208694
Volume :
37
Issue :
6
Database :
Complementary Index
Journal :
Diseases of the Esophagus
Publication Type :
Academic Journal
Accession number :
177720443
Full Text :
https://doi.org/10.1093/dote/doae007