Yung-Hung Chang1,2, Chih-Ying Chien2,3, Chih-Chi Chen2,4, Chih-Yuan Fu1,2, Chi-Hsun Hsieh1,2, Chien-Hung Liao5,6. 1. Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. 2. Chang Gung University, Taoyuan, Taiwan. 3. Department of General Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan. 4. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan. 5. Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. surgymet@gmail.com. 6. Chang Gung University, Taoyuan, Taiwan. surgymet@gmail.com.
Abstract
BACKGROUND: Corrosive ingestion results in necrosis of the digestive tract, spillage of intraluminal fluid, and spread of bacteria that threatens the lives of patients. Some authors advise extensive surgery, although others recommend conservative operation. This study presents the outcomes of the patients of corrosive injury who undergo emergent surgery. METHODS: We conducted a retrospective review including patients with corrosive injury from Jan 2007 to Dec 2013. We retrieved and analyzed the demographic characteristics, injury location and extent, endoscopic grade, presence of surgery, surgical timing and procedure, and mortality. RESULTS: The cohort consisted of 112 patients; 23 of the patients underwent an emergent operation. Patients who needed emergent surgery had the worse endoscopic severity and a higher mortality rate of 47.8% (12/23). Perforation of the digestive tract [odds ratio (OR) 13.5, p = 0.011] and unscheduled reoperation (OR 13.2, p = 0.033) were factors that predict mortality. CONCLUSION: Corrosive injury resulted in a dismal prognosis, especially when patients required an operation. The mortality is related to digestive tract perforation and unscheduled reoperation. Inadequate resection might lead to unscheduled reoperations, which lead to a dismal prognosis.
BACKGROUND: Corrosive ingestion results in necrosis of the digestive tract, spillage of intraluminal fluid, and spread of bacteria that threatens the lives of patients. Some authors advise extensive surgery, although others recommend conservative operation. This study presents the outcomes of the patients of corrosive injury who undergo emergent surgery. METHODS: We conducted a retrospective review including patients with corrosive injury from Jan 2007 to Dec 2013. We retrieved and analyzed the demographic characteristics, injury location and extent, endoscopic grade, presence of surgery, surgical timing and procedure, and mortality. RESULTS: The cohort consisted of 112 patients; 23 of the patients underwent an emergent operation. Patients who needed emergent surgery had the worse endoscopic severity and a higher mortality rate of 47.8% (12/23). Perforation of the digestive tract [odds ratio (OR) 13.5, p = 0.011] and unscheduled reoperation (OR 13.2, p = 0.033) were factors that predict mortality. CONCLUSION:Corrosive injury resulted in a dismal prognosis, especially when patients required an operation. The mortality is related to digestive tract perforation and unscheduled reoperation. Inadequate resection might lead to unscheduled reoperations, which lead to a dismal prognosis.
Authors: Mircea Chirica; Matthieu Resche-Rigon; Anne Marie Zagdanski; Matthieu Bruzzi; Damien Bouda; Eric Roland; François Sabatier; Fatiha Bouhidel; Francine Bonnet; Nicolas Munoz-Bongrand; Jean Marc Gornet; Emile Sarfati; Pierre Cattan Journal: Ann Surg Date: 2016-07 Impact factor: 12.969