Surgical tactics in iatrogenic damages of esophagus caused by treatment and diagnostic interventions

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Abstract


Aim. To analyze the causes of iatrogenic damages of esophagus, estimate the surgical tactics depending on the type and localization of perforation and terms of hospitalization.

Materials and methods. Medical documentation of 89 patients with esophageal damages of various etiology was analyzed. Iatrogenic damages of esophagus were diagnosed in 37 (41,6%) patients.

Results. The most frequent cause of esophageal perforation during treatment and diagnostic manipulations was gullet bougienage for cicatrical strictures and cardiospasm. This diagnosis was based on pains, occurring after treatment and diagnostic manipulations, which critically increased after taking liquid or food, appearance of soft tissue emphyzema of the neck and mediastinal emphysema. Presence of contrast substance leakage in roentgenoscopy permitted to determine the localization and size of esophageal defect. During the recent years, in case of diagnostic difficulties or late admission to hospital, computed tomography was used. The terms of starting treatment and complications developed substantially determined its volume and surgical tactics. Accordingly, different medical techniques were undertaken.

Conclusions. Along with traditional interventions, stenting, clipping of esophageal wounds and vacuum therapy can be used to treat iatrogenic damages, indications to which need further study.


S. A. Plaksin

Academician Ye. A. Vagner Perm State Medical University

Author for correspondence.
Email: splaksin@mail.ru

Russian Federation, Perm

доктор медицинских наук, профессор кафедры хирургии ФДПО

L. P. Kotelnikova

Academician Ye.A. Vagner Perm State Medical University

Email: splaksin@mail.ru

Russian Federation, Perm

доктор медицинских наук, профессор, зав. кафедрой хирургии ФДПО

E. E. Sablin

Perm Regional Clinical Hospital

Email: splaksin@mail.ru

Russian Federation, Perm

врач-торакальный хирург

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