Name of the Procedure:

Suture of Esophageal Wound or Injury; Cervical Approach

Summary

This procedure involves surgically stitching a wound or injury in the esophagus through an incision in the neck. It is performed to repair damage and allow the esophagus to heal properly.

Purpose

This procedure addresses esophageal injuries or perforations in the cervical (neck) region. The goal is to close the wound to prevent infection, leakage, and facilitate proper healing, thus restoring normal swallowing and digestive function.

Indications

• Esophageal trauma due to external injury or medical intervention.
• Perforation caused by foreign body ingestion.
• Severe infection or abscess formation.
• Symptoms such as pain, difficulty swallowing, or leakage of fluids into surrounding tissues.

Preparation

• Fasting for at least 8 hours before the procedure.
• Discontinuing certain medications as advised by the doctor.
• Undergoing pre-operative imaging studies like a CT scan or esophagram to assess the injury.

Procedure Description

1. The patient is positioned supine, and general anesthesia is administered.
2. An incision is made in the neck to access the esophagus.
3. The injured site is identified, and any contaminated or damaged tissue is cleaned.
4. The wound is sutured using specialized surgical stitches to ensure a secure and airtight closure.
5. The incision in the neck is closed using sutures or surgical staples.
6. A drain may be placed to prevent fluid accumulation and promote healing.

Duration

The procedure typically takes between 1 to 2 hours, depending on the extent of the injury.

Setting

The procedure is performed in a hospital operating room.

Personnel

• General or Thoracic Surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection at the surgical site.
• Leakage from the esophagus causing mediastinitis.
• Damage to surrounding structures like nerves or blood vessels.
• Anesthesia-related complications.
• Scar formation or stricture (narrowing) of the esophagus.

Benefits

• Effective closure of the esophageal wound.
• Prevention of infections and complications.
• Restoration of normal esophageal function.
• Improvement in symptoms like pain and swallowing difficulties.

Recovery

• Hospital stay for a few days with monitoring.
• Pain management with prescribed medications.
• Gradual reintroduction of oral intake starting with liquids.
• Instructions on wound care and activity restrictions.
• Follow-up appointments to monitor healing and ensure proper esophageal function.

Alternatives

• Endoscopic repair for less severe injuries.
• Conservative management with IV antibiotics and nutrition, if the injury is minimal.
• Pros: Less invasive options may have fewer risks and quicker recovery.
• Cons: Not suitable for severe or multiple injuries, slower healing.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, they may experience neck discomfort, soreness, and difficulty swallowing initially. Pain management will include medications, and instructions will be provided to ensure comfort and proper healing.