Menduh Oruc, Atalay Sahin
Surgical repair remains an effective and preferable treatment option for selected cases of esophageal injury. Early diagnosis and appropriate management play a crucial role in reducing morbidity and mortality. Clinical decision-making should consider anatomical location, etiology, and the patient's general condition.
INTRODUCTION: The esophagus is a complex anatomical structure extending through the neck, thorax, and abdomen, and injuries can occur at any of these levels. Although rare, esophageal injuries constitute clinical emergencies that may lead to high morbidity and mortality, especially when diagnosis and treatment are delayed.
AIM: This study aims to evaluate the demographic, clinical, and prognostic features of esophageal injuries managed with surgical intervention.
MATERIAL AND METHODS: This retrospective study includes 75 patients who underwent surgical treatment for esophageal injury between 2003 and 2023. Demographic data, injury etiology, anatomical localization, treatment methods, complication rates, mortality, and length of hospital stay were analyzed.
RESULTS: The mean age of the patients was 35.24 ±22.06 years, with 64% being male. Of the injuries, 78.7% were traumatic, and 21.3% were iatrogenic in origin. Cervical esophageal injuries accounted for 53.3%, while thoracic injuries represented 46.7%. Primary surgical repair was performed in 66.7% of patients, whereas 33.3% were managed conservatively based on clinical indications. Delayed diagnosis emerged as the most significant factor contributing to increased complication and mortality rates. Higher mortality was particularly observed in cervical esophageal injuries, where non-surgical management was more commonly preferred. The most frequent complication was mediastinitis, and the overall mortality rate was determined to be 12%. The mean length of hospital stay was 25.69 ±25.508 days, influenced by the timing of diagnosis, etiology, and accompanying pathologies.
CONCLUSIONS: Surgical repair remains an effective and preferable treatment option for selected cases of esophageal injury. Early diagnosis and appropriate management play a crucial role in reducing morbidity and mortality. Clinical decision-making should consider anatomical location, etiology, and the patient's general condition.