Title : Endoscopic self expandable metal stent versus endoscopy vacuum therapy for traumatic esophageal perforations: A retrospective cohort study
Abstract:
Traumatic esophageal perforations (TEP) are a grave medical condition and require immediate intervention. Techniques such as Esophageal Self-Expandable Metal Stent (E-SEMS) and Endoscopic Vacuum Therapy (EVT) show promise in reducing tissue damage and controlling esophageal leakage. The present study aims to compare the application of EVT to E-SEMS placement in TEP.
Methods: Retrospective cohort study valuated 30 patients with TEP. The E-SEMS and EVT groups were assessed for time of hospitalization, treatment duration, costs, and clinical outcome.
Results: Patients treated with EVT (24.4 ± 13.2) demonstrated significantly shorter treatment duration (p < 0.005) compared to the group treated with E-SEMS (45.8 ± 12.9) and patients submitted to E-SEMS demonstrated a significant reduction (p = 0.02) in the time of hospitalization compared to the EVT (34 ± 2 vs 82 ± 5 days). Both groups demonstrated a satisfactory discharge rate (E-SEMS 93.7% vs EVT 71.4%) but did not show statistically significant difference (p = 0.3155). E-SEMS treatment had a lower mean cost than EVT (p < 0.05). Descriptive statistics were utilized, arranged in table form, where frequencies, percentages, mean, median, and standard deviation of the study variables were calculated and counted. The Fisher's Exact Test was used to evaluate the relationship between two categorical variables. To evaluate differences between means and central points, the parametric t-test was utilized. Comparisons with p value up to 0.05 were considered significant.
Conclusion: E-SEMS showed a shorter time of hospitalization, but a longer duration of treatment compared to EVT. The placement of E-SEMS and EVT had the same clinical outcome. Treatment with E-SEMS had a lower cost compared with EVT.
Audience Take Away Notes:
- This is unprecedented study in the world carried out in on of the most violent regions of the world- northeast of Brazil – which compares two endoscopic techniques that are less invasive than traditional surgery for the treatment of traumatic esophageal injuries.
- This study allows us to evaluate the possibility of treating severe trauma of the esophagus using less invasive techniques than traditional surgery.
- This study allows us to compare two excellent, non-invasive techniques – E-SEMS x EVT – for treating esophageal
- treating esophageal trauma.
- This study finally opens up a huge space for the endoscopic treatment in the trauma.
