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See Latest ArticlesConservative management of iatrogenic esophageal perforation in head and neck cancer patients with esophageal stricture
Otolaryngology Head and Neck Surgery, 04/01/09
Mao JC et al. - In head and neck cancer patients with post-treatment esophageal stricture, iatrogenic cervical esophageal perforations can often be safely managed conservatively. The criteria are: prompt diagnosis within 1 hr, small perforation, penetrating type of perforation with circumferential mucosal contact, proximal or cervical esophageal location, and stabilization and improvement of clinical signs and symptoms for 24 hrs after initial ICU management.
Methods- Aim was to evaluate the efficacy of conservative management of iatrogenic esophageal perforation following dilatation of a stricture secondary to the treatment of head and neck cancer
- Retrospective chart review of 24 pts
- Of these, 8 head and neck cancer pts had esophageal stricture and underwent dilatation with subsequent esophageal perforation
- 6 pts were managed conservatively; 2 were managed surgically
- All 8 pts had radiation, 6 had chemotherapy, and 5 had surgery as part of their oncologic treatment
- Stricture site was at the cricopharyngeus or neopharynx
- Perforation size was estimated at 3-7 mm in conservative pts and approx. 10 mm in surgical pts
- All pts survived to be discharged from the hospital and diet was tube feeds
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