Foregut caustic injuries: results of the world society of emergency surgery consensus conference
Year: 2015
Type: article
Abstract: INTRODUCTION: Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeutic guidelines are available. PURPOSE OF THE STUDY: The aim of this study was to provide an evidence-based international consensus on primary and secondary prevention, diagnosis, staging, and treatment of this life-threatening and potentially disabling condition. METHODS: An extensive literature search was performed by an international panel of experts under the auspices of the World Society of Emergency Surgery (WSES). The level of evidence of the screened publications was graded using the Oxford 2011 criteria. The level of evidence of the literature and the main topics regarding foregut caustic injuries were discussed during a dedicated meeting in Milan, Italy (April 2015), and during the 3rd Annual Congress of the World Society of Emergency Surgery in Jerusalem, Israel (July 2015). RESULTS: One-hundred-forty-seven full papers which addressed the relevant clinical questions of the research were admitted to the consensus conference. There was an unanimous consensus on the fact that the current literature on foregut caustic injuries lacks homogeneous classification systems and prospective methodology. Moreover, the non-standardized definition of technical and clinical success precludes any accurate comparison of therapeutic modalities. Key recommendations and algorithms based on expert opinions, retrospective studies and literature reviews were proposed and approved during the final consensus conference. The clinical practice guidelines resulting from the consensus conference were approved by the WSES council. CONCLUSIONS: The recommendations emerging from this consensus conference, although based on a low level of evidence, have important clinical implications. A world registry of foregut caustic injuries could be useful to collect a homogeneous data-base for prospective clinical studies that may help improving the current clinical practice guidelines.
Authors: Luigi Bonavina, Mircea Chirica, Ognjan Skrobic, Yoram Kluger, Nelson A. Andreollo, Sandro Contini, Aleksander Simic, Luca Ansaloni, Fausto Catena, Gustavo P. Fraga, Carlo Locatelli, Osvaldo Chiara, Jeffry Kashuk, Federico Coccolini, Yuri Macchitella, Massimiliano Mutignani, Cesare Cutrone, Marco Dei Poli, Tino Valetti, Emanuele Asti, Michael Kelly, Predrag Pesko
Institutions: University of Milan, IRCCS Policlinico San Donato, Hôpital Saint-Louis, University of Belgrade, Rambam Health Care Campus, Universidade Estadual de Campinas (UNICAMP), University of Parma, Ospedale Papa Giovanni XXIII, Ospedale di Parma, University of Pavia, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Hebrew University of Jerusalem, Azienda Ospedale - Università Padova, Wagga Wagga Base Hospital
Language: English
Topic: Foreign Body Medical Cases
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,990
OpenAlex ID: W2099648748