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- Title
Foregut caustic injuries: results of the world society of emergency surgery consensus conference.
- Authors
Bonavina, Luigi; Chirica, Mircea; Skrobic, Ognjan; Kluger, Yoram; Andreollo, Nelson A.; Contini, Sandro; Simic, Aleksander; Ansaloni, Luca; Catena, Fausto; Fraga, Gustavo P.; Locatelli, Carlo; Chiara, Osvaldo; Kashuk, Jeffry; Coccolini, Federico; Macchitella, Yuri; Mutignani, Massimiliano; Cutrone, Cesare; Dei Poli, Marco; Valetti, Tino; Asti, Emanuele
- 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.
- Subjects
ISRAEL; GASTROINTESTINAL surgery; GASTROINTESTINAL system injuries; CONFERENCES &; conventions; ALGORITHMS; CHEMICAL burns; DIGESTIVE organ surgery; EMERGENCY medical services; EMERGENCY medicine; HOSPITAL emergency services; MEDICAL information storage &; retrieval systems; MEDICAL protocols; MEDLINE; NUTRITION; SYSTEMATIC reviews; SEVERITY of illness index; ENDOSCOPIC gastrointestinal surgery
- Publication
World Journal of Emergency Surgery, 2015, Vol 10, Issue 1, p1
- ISSN
1749-7922
- Publication type
Article
- DOI
10.1186/s13017-015-0039-0