Surgical Management Strategies for Combined Post-Burn Esophageal and Gastric Strictures with Equivalent Clinical Stenosis
Abstract
ObjectivesThis study aimed to analyze the patterns and surgical management strategies of combined esophageal and gastric chemical burns, with a focus on the types of gastric involvement and appropriate surgical interventions based on the stage of injury. MethodsA retrospective analysis was conducted based on clinical experience from the Department of Esophagus and Stomach Surgery at the Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov. A total of 247 patients with post-burn cicatricial strictures of the esophagus and stomach (PBCSES) were examined and treated between 1990 and 2022. The extent and location of gastric injuries were categorized, and surgical approaches were evaluated based on the timing and severity of the burns. ResultsAmong the 247 patients, the distribution of combined gastric lesions was as follows: isolated pylorus involvement in 24 cases (9.7%), antrum in 51 cases (20.6%), both pylorus and antrum in 143 cases (57.9%), body of the stomach in 7 cases (2.8%), antrum and body in 11 cases (4.5%), subtotal gastric involvement in 4 cases (1.6%), and total gastric involvement in 7 cases (2.8%). Combined damage to the esophagus and stomach, with predominance of one organ, was observed in approximately 50% of cases. Conclusion Surgical intervention for early-stage chemical burns is generally limited to symptomatic and supportive treatments due to incomplete scarring. In contrast, late-stage burns may be amenable to radical surgical procedures, provided that the patient's nutritional (alimentary) status is adequately maintained. In cases of compromised nutritional status, symptomatic surgical approaches remain the primary option.