{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:07:27Z","timestamp":1774354047516,"version":"3.50.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Trauma-related esophageal injuries (TEIs) are a rare but highly lethal condition. The presentation of TEIs is very diverse depending on the location and mechanism of injury (blunt vs. penetrating), as well as the presence or absence of concurrent injuries. The aim of the present systematic review and meta-analysis is to delineate the clinical features impacting TEI management. A systematic review of the Medline, Embase, and web of science databases was undertaken for studies reporting on patients with TEIs. A random effects model was employed in the meta-analysis of aggregated data. Eleven studies, incorporating 4605 patients, were included, with a pooled mortality rate of 19% (95% confidence interval (CI) 13\u201325%). Penetrating injuries were 34% more likely to occur (RR 0.66, 95% CI 0.49\u20130.89, P\u2009=\u20090.01), predominantly in the neck compartment. Surgery was employed in 53% of cases (95% CI 32\u201373%), with 68% of patients having associated injuries (95% CI 43\u201394%). In terms of choice of surgical repair technique, primary suture repair was most frequently reported, irrespective of injury location. Postoperative drainage was employed in 27% of the cases and was more common following repair of thoracic esophageal injuries. The estimated dependence on mechanical ventilation was 5.91\u00a0days (95% CI 5.1\u20136.72\u00a0days), while the length of stay in the intensive care unit averaged 7.89\u00a0days (95% CI 7.14\u20138.65\u00a0days). TEIs are uncommon injuries in trauma patients, associated with considerable mortality and morbidity. Open suture repair of ensuing esophageal defects is by large the most employed approach, while stenting may be indicated in carefully selected cases.<\/jats:p>","DOI":"10.1093\/dote\/doae007","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T07:39:47Z","timestamp":1708155587000},"source":"Crossref","is-referenced-by-count":5,"title":["Current aspects in the management of esophageal trauma: a systematic review and proportional meta-analysis"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2319-4923","authenticated-orcid":false,"given":"Dimitrios","family":"Papaconstantinou","sequence":"first","affiliation":[{"name":"Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital , Athens , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouil I","family":"Kapetanakis","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National and Kapodistrian University of Athens, Attikon University Hospital , Athens , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0272-3259","authenticated-orcid":false,"given":"Adam","family":"Mylonakis","sequence":"additional","affiliation":[{"name":"First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital , Athens , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0042-436X","authenticated-orcid":false,"given":"Spyridon","family":"Davakis","sequence":"additional","affiliation":[{"name":"First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital , Athens , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathios","family":"Kotidis","sequence":"additional","affiliation":[{"name":"Fourth Department of Surgery, Aristotle University of Thessaloniki, General Hospital \u201cGeorge Papanikolaou\u201d , Thessaloniki , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos","family":"Tagkalos","sequence":"additional","affiliation":[{"name":"Department of General , Visceral and Transplant Surgery, , Mainz , Germany"},{"name":"University Medical Center of the Johannes Gutenberg University , Visceral and Transplant Surgery, , Mainz , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Rouvelas","sequence":"additional","affiliation":[{"name":"Center for Digestive Diseases , Karolinska University Hospital and the Division of Surgery and Oncology, Department of Clinical Science Intervention and Technology (CLINTEC), , Stockholm , Sweden"},{"name":"Karolinska Institute , Karolinska University Hospital and the Division of Surgery and Oncology, Department of Clinical Science Intervention and Technology (CLINTEC), , Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Schizas","sequence":"additional","affiliation":[{"name":"First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital , Athens , Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"issue":"7","key":"2024060203013586900_ref1","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/dote.12132","article-title":"Pathogenesis and outcomes of traumatic injuries of the esophagus","volume":"27","author":"Makhani","year":"2014","journal-title":"Dis Esophagus"},{"issue":"10","key":"2024060203013586900_ref2","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1177\/000313481908501012","article-title":"Esophageal trauma: analysis of incidence, morbidity, and mortality","volume":"85","author":"Gambhir","year":"2019","journal-title":"Am Surg"},{"issue":"1","key":"2024060203013586900_ref3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4103\/0974-2700.150394","article-title":"Preoperative evaluation of penetrating esophageal trauma in the current era: An analysis of the National Trauma Data Bank","volume":"8","author":"Yeh","year":"2015","journal-title":"J Emerg Trauma Shock"},{"issue":"3","key":"2024060203013586900_ref4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003583","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"18","author":"Page","year":"2021","journal-title":"PLoS Med"},{"issue":"8","key":"2024060203013586900_ref5","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1007\/s00268-012-1602-4","article-title":"Esophagogastric trauma in Scotland","volume":"36","author":"Skipworth","year":"2012","journal-title":"World J Surg"},{"issue":"5","key":"2024060203013586900_ref6","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1097\/TA.0000000000001563","article-title":"Defining the gastroesophageal junction in trauma: Epidemiology and management of a challenging injury","volume":"83","author":"Schellenberg","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"2024060203013586900_ref7","doi-asserted-by":"crossref","first-page":"E1109","DOI":"10.1002\/lary.29088","article-title":"Blunt versus penetrating neck trauma: A retrospective Cohort study","volume":"131","author":"Forner","year":"2021","journal-title":"Laryngoscope"},{"key":"2024060203013586900_ref8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1749-8090-5-46","article-title":"Factors affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single center","volume":"5","author":"Onat","year":"2010","journal-title":"J Cardiothorac Surg"},{"issue":"11","key":"2024060203013586900_ref9","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1002\/bjs.4760","article-title":"Factors affecting outcome in penetrating oesophageal trauma","volume":"91","author":"Smakman","year":"2004","journal-title":"Br J Surg"},{"issue":"7","key":"2024060203013586900_ref10","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/s00383-019-04481-6","article-title":"Comparative analysis of traumatic esophageal injury in pediatric and adult populations","volume":"35","author":"Xu","year":"2019","journal-title":"Pediatr Surg Int"},{"issue":"4","key":"2024060203013586900_ref11","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1097\/TA.0000000000002841","article-title":"Contemporary management of traumatic cervical and thoracic esophageal perforation: The results of an Eastern Association for the Surgery of Trauma multi-institutional study","volume":"89","author":"Raff","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2024060203013586900_ref12","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.amsu.2019.06.011","article-title":"Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series","volume":"44","author":"V\u00e1zquez-Rodr\u00edguez","year":"2019","journal-title":"Ann Med Surg (Lond)"},{"issue":"8","key":"2024060203013586900_ref13","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1097\/00005373-198508000-00009","article-title":"Management of blunt and penetrating external esophageal trauma","volume":"25","author":"Glatterer","year":"1985","journal-title":"J Trauma"},{"issue":"1","key":"2024060203013586900_ref14","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13017-017-0131-8","article-title":"Non-iatrogenic esophageal injury: a retrospective analysis from the National Trauma Data Bank","volume":"12","author":"Aiolfi","year":"2017","journal-title":"World J Emerg Surg"},{"issue":"1","key":"2024060203013586900_ref15","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13017-019-0245-2","article-title":"Esophageal emergencies: WSES guidelines","volume":"14","author":"Chirica","year":"2019","journal-title":"World J Emerg Surg"},{"issue":"6","key":"2024060203013586900_ref16","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.clinimag.2015.07.021","article-title":"Can computed tomography esophagography reliably diagnose traumatic penetrating upper digestive tract injuries?","volume":"39","author":"Conradie","year":"2015","journal-title":"Clin Imaging"},{"issue":"7","key":"2024060203013586900_ref17","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1111\/j.1572-0241.2000.02165.x","article-title":"Role of flexible endoscopy in the evaluation of possible esophageal trauma after penetrating injuries","volume":"95","author":"Srinivasan","year":"2000","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"2024060203013586900_ref18","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1007\/s00268-013-1951-7","article-title":"Current treatment and outcome of esophageal perforations in adults: systematic review and meta-analysis of 75 studies","volume":"37","author":"Biancari","year":"2013","journal-title":"World J Surg"},{"issue":"6","key":"2024060203013586900_ref19","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1097\/TA.0000000000000772","article-title":"Western Trauma Association Critical Decisions in Trauma: diagnosis and management of esophageal injuries","volume":"79","author":"Biffl","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"2024060203013586900_ref20","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s00423-013-1143-9","article-title":"Changes in the outcomes of severe trauma patients from 15-year experience in a Western European trauma ICU of Emilia Romagna region (1996-2010). A population cross-sectional survey study","volume":"399","author":"Di Saverio","year":"2014","journal-title":"Langenbecks Arch Surg"},{"issue":"4","key":"2024060203013586900_ref21","doi-asserted-by":"crossref","first-page":"R143","DOI":"10.1186\/cc13976","article-title":"Factors influencing lengths of stay in the intensive care unit for surviving trauma patients: a retrospective analysis of 30,157 cases","volume":"18","author":"B\u00f6hmer","year":"2014","journal-title":"Crit Care"},{"issue":"11","key":"2024060203013586900_ref22","doi-asserted-by":"crossref","first-page":"6344","DOI":"10.1007\/s00464-020-08103-4","article-title":"Length of hospital stay after uncomplicated esophagectomy. Hospital variation shows room for nationwide improvement","volume":"35","author":"Voeten","year":"2021","journal-title":"Surg Endosc"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/37\/6\/doae007\/58038946\/doae007.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/37\/6\/doae007\/58038946\/doae007.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T03:01:53Z","timestamp":1717297313000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doae007\/7608770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,15]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,2,15]]},"published-print":{"date-parts":[[2024,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doae007","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,2,15]]},"article-number":"doae007"}}