AI Article Synopsis
- The study investigates factors impacting the treatment and outcomes of iatrogenic cervical oesophageal and hypopharyngeal perforations (iCEHPs) by analyzing data from 24 patients treated from 2004 to 2021.
- It was found that surgical neck exploration was the most common treatment, especially for uncontained perforations, and patients managed surgically typically had higher C-reactive protein (CRP) levels.
- Key findings highlighted that delayed diagnosis increases mortality risk, and a history of neck irradiation significantly worsens patient prognosis.
Article Abstract
Objective: The study aimed to identify factors affecting the management and prognosis of iatrogenic cervical oesophageal and hypopharyngeal perforations (iCEHPs).
Methods: We retrospectively analysed 24 patients treated for iCEHP between 2004 and 2021 at a tertiary university medical centre. Data on demographics, clinical features, imaging, management and outcomes were collected. Factors associated with primary management and patient outcome were assessed.
Results: The most common management approach was surgical neck exploration (15 patients, 62.5%). Surgical management was used in 93% of uncontained perforations compared to 11% of contained perforations (p < 0.001). Surgically-treated patients had higher levels of C-reactive protein (CRP) than conservatively-treated patients (median, 18.3 4.8 mg/dL; p = 0.001). Delayed diagnosis (≥ 24 hours) was associated with increased mortality (100 5%; p = 0.011). The mortality rate was significantly higher in patients who had a history of neck irradiation than in patients who did not (67 5%; p = 0.032).
Conclusions: Early diagnosis of iCEHP improves outcomes. The appropriate management should be carefully selected on the basis of CRP level and imaging findings. Prior neck radiation is a poor prognostic factor.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441517 | PMC |
| http://dx.doi.org/10.14639/0392-100X-N2905 | DOI Listing |
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