Research Article
The Role of Second-look Endoscopy in Severe Esophageal Caustic Injury
Le Puo-Hsien1,2, Seak Chen-June3,4, Chiu Cheng-Tang1,4, Chen Tsung-Hsing1,4, Kang Shih-Ching5 and Cheng Hao-Tsai1,4,6*1Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
2Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
3Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
4Chang Gung University, College of Medicine, Taoyuan, Taiwan
5Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
6Graduate Institute of Clinical Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- *Corresponding Author:
- Cheng Hao-Tsai
Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital
Chang Gung University College of Medicine, No.5 Fu-Shin Street
Taoyuan 333, Taiwan, Republic of China
Tel: +886-3-3281200
Fax: +886-3-3272236
E-mail: howardandbetty@yahoo.com.tw
Received date: July 18, 2017; Accepted date: August 02, 2017; Published date: August 09, 2017
Citation: Puo-Hsien L, Chen-June S, Cheng-Tang C, Tsung-Hsing C, Shih-Ching K, et al. (2017) The Role of Second-look Endoscopy in Severe Esophageal Caustic Injury. J Gastrointest Dig Syst 7:518. doi:10.4172/2161-069X.1000518
Copyright: © 2017 Puo-Hsien Le, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Severe caustic ingestion often leads to multiple complications and high mortality rate. Esophagogastroduodenoscopy is recommended during the first 24 hours for severity and extent evaluation, but it seems insufficient to guide further managements in severe caustic injury patients due to rapid progression and variable clinical conditions. Therefore, we tried to evaluate the safety and role of second-look endoscopy in these patients in 1-2 weeks later.
We retrospectively collected severe esophageal caustic injury (grade 2b, 3a, 3b) adults with and without secondlook endoscopy in subacute stage (6th-14th days after caustic injury) in Linkou Change Gung Memorial Hospital during 2011/1-2014/11. They were divided in to once endoscopy group and second-look endoscopic group according to the patients with second-look endoscopy or not. They were further matched with the same cause of caustic injury, properties, injury grading, and then selected with Excel RAND function. There were 26 patients in both groups.
The average timing of second-look endoscopy was 10.23 ± 3.166 (mean ± SD) days after caustic ingestion. The hospital stay was significantly shorter in the second-look endoscopy group (24.92 ± 17.50 days, 54.38 ± 43.73 days, P=0.002). However, the complication rate was not statistically significant between these two groups.
In conclusion, second-look endoscopy is safe and might shorten the hospital stay. However, prospective, randomized and larger sample size studies are needed to support the finding.
