Surgical management of partial dentures in the cervicothoracic esophagus

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 13; no. 3; pp. 270 - 275
• Main Authors: Sawayama, Hiroshi, Miyanari, Nobutomo, Morita, Keisuke, Matsumoto, Katsutaka, Mizumoto, Takao, Kubota, Tatsuo, Haga, Yoshio, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.07.2016; Springer Nature B.V
• Subjects: Dentures; Endoscopy; Esophagus; Gastroenterology; Medical diagnosis; Medicine; Medicine & Public Health; Original Article; Ostomy; Surgical Oncology; Sutures; Thoracic Surgery; Tracheotomy; Cervicothoracic esophagus; Partial denture; Esophageal foreign body
• ISSN: 1612-9059; 1612-9067
• DOI: 10.1007/s10388-016-0524-x

Introduction Endoscopic extraction is the first choice for removing esophageal foreign bodies, but dentures with complicated sharp clasps that invaginate the esophageal mucosa are difficult to remove endoscopically; surgical management is required for patients who have ingested dentures. Methods Seven patients who underwent emergency surgery for dentures with complicated sharp clasps lodged in the cervicothoracic esophagus were enrolled. We describe the surgical management and postoperative courses of these patients. Results There were four male and three female patients with an average age of 78.4 years (range 71–84). All cases were difficult to diagnosis by interview because the patients had dementia or schizophrenia. Emergency surgery was performed for seven patients. A skin incision was made along the anterior border of the left sternocleidomastoid muscle. The esophageal wall was opened and the denture was extracted. The esophageal wall was repaired with interrupted sutures. A tracheostomy was constructed in three cases, and bilateral drainage was performed in two cases. However, tracheostomy and bilateral drainage were not necessary, and the subsequent four patients received only left-sided drainage tubes without tracheostomy. All seven patients progressed favorably postoperatively. No ruptured sutures or esophageal stenosis occurred. Conclusion The outcomes of all seven patients who underwent surgical denture removal were satisfactory. Tracheostomy and bilateral drainage may not be essential.