Operative versus nonoperative techniques in emergency management of iatrogenic esophageal perforations

Abstract

Background Iatrogenic esophageal perforation is a rare, challenging, and life-threatening clinical condition. It can be cervical, thoracic, or abdominal. Its diagnosis depends on clinical suspicion combined with radiological modalities. It can be managed by either nonoperative or operative means. The aim of the study is to evaluate the efficacy of nonoperative compared with operative management of iatrogenic esophageal perforations. Study design This was a nonrandomized controlled study. Patients and methods This study included 30 patients presented with iatrogenic esophageal perforations after undergoing upper gastrointestinal tract endoscopic procedures. There were two groups of patients: group A included 12 patients who were subjected to nonoperative management, and group B included 18 patients who were subjected to operative management. Results The mean age of group A patients was 43 years, whereas for group B patients was 46 years. Most of the group A patients were males (66.66%), and 61.2% of the group B patients were males. The average length of hospital stay was 11 days (range, 8–15 days) for the group A patients and 14 days (range, 9–22 days) for the group B patients. Mortality was 16.6 and 22.3% for group A and group B, respectively. Conclusion Iatrogenic esophageal perforation is a rare and dangerous event. It can be managed by either nonoperative or operative techniques. Both methods have nearly the same success and morbidity and mortality rates when applied; however, the nonoperative techniques can be used only in certain cases under specific criteria.