Gastric conservation in severe caustic lesions of the digestive tract : is it legitimate?
OBJECTIVE: To evaluate advantages and drawbacks of a controlled conservative management of patients with severe gastric caustic injuries.
METHODS: Among 40 patients with severe caustic gastric burns (> IIb), 28 with stade III lesions (mosaic necrosis: n = 10, extensive or circumferential necrosis: n = 18) were managed prospectively from 1990 to 1998. Twenty-two patients had associated stage III oesophageal lesions and 6 had stage III duodenal lesions. All patients were followed up by daily surgical examination. Total gastrectomy with esophageal exclusion or stripping was performed in case of perforation.
RESULTS: Five immediate and 7 secondary total gastrectomies, two associated esophagectomies and two jejunal resections were performed. Mortality rate was 18% (5/28). Sixteen gastric preservations (60%) were achieved, including 7 complete and 9 partial because of gastric stricture. Eighteen esophagoplasties for oesophageal strictures or after gastrectomy were performed without mortality.
CONCLUSION: Stage III caustic injuries of the stomach, when they are not immediately life-threatening, do not systematically require total gastrectomy. A strict conservative attitude can be done with significant morbidity and acceptable mortality and significantly raises the numbers of preserved stomach.
| Errataetall: | |
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| Medienart: |
Artikel |
| Erscheinungsjahr: |
2003 |
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| Erschienen: |
2003 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:128 |
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| Enthalten in: |
Annales de chirurgie - 128(2003), 1 vom: 21. Feb., Seite 11-7 |
| Sprache: |
Französisch |
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| Weiterer Titel: |
Conservation gastrique dans les lésions caustiques sévères du tube digestif: est-elle légitime? |
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| Beteiligte Personen: |
Pruvot, F R [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 04.04.2003 Date Revised 06.11.2019 published: Print CommentOn: Ann Chir. 2003 Feb;128(1):2-3. - PMID 12600321 Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM123766737 |
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| 245 | 1 | 0 | |a Gastric conservation in severe caustic lesions of the digestive tract |b is it legitimate? |
| 246 | 3 | 3 | |a Conservation gastrique dans les lésions caustiques sévères du tube digestif: est-elle légitime? |
| 264 | 1 | |c 2003 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 04.04.2003 | ||
| 500 | |a Date Revised 06.11.2019 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentOn: Ann Chir. 2003 Feb;128(1):2-3. - PMID 12600321 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To evaluate advantages and drawbacks of a controlled conservative management of patients with severe gastric caustic injuries | ||
| 520 | |a METHODS: Among 40 patients with severe caustic gastric burns (> IIb), 28 with stade III lesions (mosaic necrosis: n = 10, extensive or circumferential necrosis: n = 18) were managed prospectively from 1990 to 1998. Twenty-two patients had associated stage III oesophageal lesions and 6 had stage III duodenal lesions. All patients were followed up by daily surgical examination. Total gastrectomy with esophageal exclusion or stripping was performed in case of perforation | ||
| 520 | |a RESULTS: Five immediate and 7 secondary total gastrectomies, two associated esophagectomies and two jejunal resections were performed. Mortality rate was 18% (5/28). Sixteen gastric preservations (60%) were achieved, including 7 complete and 9 partial because of gastric stricture. Eighteen esophagoplasties for oesophageal strictures or after gastrectomy were performed without mortality | ||
| 520 | |a CONCLUSION: Stage III caustic injuries of the stomach, when they are not immediately life-threatening, do not systematically require total gastrectomy. A strict conservative attitude can be done with significant morbidity and acceptable mortality and significantly raises the numbers of preserved stomach | ||
| 650 | 4 | |a Comment | |
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Caustics |2 NLM | |
| 700 | 1 | |a Brami, F |e verfasserin |4 aut | |
| 700 | 1 | |a Saulnier, F |e verfasserin |4 aut | |
| 700 | 1 | |a Gambiez, L |e verfasserin |4 aut | |
| 700 | 1 | |a Roumilhac, D |e verfasserin |4 aut | |
| 700 | 1 | |a Chambon, J P |e verfasserin |4 aut | |
| 700 | 1 | |a Paris, J C |e verfasserin |4 aut | |
| 700 | 1 | |a Quandalle, P |e verfasserin |4 aut | |
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