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Acute esophageal necrosis: A systematic review and pooled analysis
BACKGROUND: Acute esophageal necrosis (AEN) is a rare entity with multifactorial etiology, usually presenting with signs of upper gastrointestinal bleeding. AIM: To systematically review all available data on demographics, clinical features, outcomes and management of this medical condition. METHODS...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061242/ https://www.ncbi.nlm.nih.gov/pubmed/32218893 http://dx.doi.org/10.4240/wjgs.v12.i3.104 |
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author | Schizas, Dimitrios Theochari, Nikoletta A Mylonas, Konstantinos S Kanavidis, Prodromos Spartalis, Eleftherios Triantafyllou, Stamatina Economopoulos, Konstantinos P Theodorou, Dimitrios Liakakos, Theodore |
author_facet | Schizas, Dimitrios Theochari, Nikoletta A Mylonas, Konstantinos S Kanavidis, Prodromos Spartalis, Eleftherios Triantafyllou, Stamatina Economopoulos, Konstantinos P Theodorou, Dimitrios Liakakos, Theodore |
author_sort | Schizas, Dimitrios |
collection | PubMed |
description | BACKGROUND: Acute esophageal necrosis (AEN) is a rare entity with multifactorial etiology, usually presenting with signs of upper gastrointestinal bleeding. AIM: To systematically review all available data on demographics, clinical features, outcomes and management of this medical condition. METHODS: A systematic literature search was performed with respect to the PRISMA statement (end-of-search date: October 24, 2018). Data on the study design, interventions, participants and outcomes were extracted by two independent reviewers. RESULTS: Seventy-nine studies were included in this review. Overall, 114 patients with AEN were identified, of whom 83 were males and 31 females. Mean patient age was 62.1 ± 16.1. The most common presenting symptoms were melena, hematemesis or other manifestations of gastric bleeding (85%). The lower esophagus was most commonly involved (92.9%). The most widely implemented treatment modality was conservative treatment (75.4%), while surgical or endoscopic intervention was required in 24.6% of the cases. Mean overall follow-up was 66.2 ± 101.8 d. Overall 29.9% of patients died either during the initial hospital stay or during the follow-up period. Gastrointestinal symptoms on presentation [Odds ratio 3.50 (1.09-11.30), P = 0.03] and need for surgical or endoscopic treatment [surgical: Odds ratio 1.25 (1.03-1.51), P = 0.02; endoscopic: Odds ratio 1.4 (1.17-1.66), P < 0.01] were associated with increased odds of complications. A sub-analysis separating early versus late cases (after 2006) revealed a significantly increased frequency of surgical or endoscopic intervention (9.7 % vs 30.1% respectively, P = 0.04) CONCLUSION: AEN is a rare condition with controversial pathogenesis and unclear optimal management. Although the frequency of surgical and endoscopic intervention has increased in recent years, outcomes have remained the same. Therefore, further research work is needed to better understand how to best treat this potentially lethal disease. |
format | Online Article Text |
id | pubmed-7061242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-70612422020-03-27 Acute esophageal necrosis: A systematic review and pooled analysis Schizas, Dimitrios Theochari, Nikoletta A Mylonas, Konstantinos S Kanavidis, Prodromos Spartalis, Eleftherios Triantafyllou, Stamatina Economopoulos, Konstantinos P Theodorou, Dimitrios Liakakos, Theodore World J Gastrointest Surg Systematic Reviews BACKGROUND: Acute esophageal necrosis (AEN) is a rare entity with multifactorial etiology, usually presenting with signs of upper gastrointestinal bleeding. AIM: To systematically review all available data on demographics, clinical features, outcomes and management of this medical condition. METHODS: A systematic literature search was performed with respect to the PRISMA statement (end-of-search date: October 24, 2018). Data on the study design, interventions, participants and outcomes were extracted by two independent reviewers. RESULTS: Seventy-nine studies were included in this review. Overall, 114 patients with AEN were identified, of whom 83 were males and 31 females. Mean patient age was 62.1 ± 16.1. The most common presenting symptoms were melena, hematemesis or other manifestations of gastric bleeding (85%). The lower esophagus was most commonly involved (92.9%). The most widely implemented treatment modality was conservative treatment (75.4%), while surgical or endoscopic intervention was required in 24.6% of the cases. Mean overall follow-up was 66.2 ± 101.8 d. Overall 29.9% of patients died either during the initial hospital stay or during the follow-up period. Gastrointestinal symptoms on presentation [Odds ratio 3.50 (1.09-11.30), P = 0.03] and need for surgical or endoscopic treatment [surgical: Odds ratio 1.25 (1.03-1.51), P = 0.02; endoscopic: Odds ratio 1.4 (1.17-1.66), P < 0.01] were associated with increased odds of complications. A sub-analysis separating early versus late cases (after 2006) revealed a significantly increased frequency of surgical or endoscopic intervention (9.7 % vs 30.1% respectively, P = 0.04) CONCLUSION: AEN is a rare condition with controversial pathogenesis and unclear optimal management. Although the frequency of surgical and endoscopic intervention has increased in recent years, outcomes have remained the same. Therefore, further research work is needed to better understand how to best treat this potentially lethal disease. Baishideng Publishing Group Inc 2020-03-27 2020-03-27 /pmc/articles/PMC7061242/ /pubmed/32218893 http://dx.doi.org/10.4240/wjgs.v12.i3.104 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Systematic Reviews Schizas, Dimitrios Theochari, Nikoletta A Mylonas, Konstantinos S Kanavidis, Prodromos Spartalis, Eleftherios Triantafyllou, Stamatina Economopoulos, Konstantinos P Theodorou, Dimitrios Liakakos, Theodore Acute esophageal necrosis: A systematic review and pooled analysis |
title | Acute esophageal necrosis: A systematic review and pooled analysis |
title_full | Acute esophageal necrosis: A systematic review and pooled analysis |
title_fullStr | Acute esophageal necrosis: A systematic review and pooled analysis |
title_full_unstemmed | Acute esophageal necrosis: A systematic review and pooled analysis |
title_short | Acute esophageal necrosis: A systematic review and pooled analysis |
title_sort | acute esophageal necrosis: a systematic review and pooled analysis |
topic | Systematic Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061242/ https://www.ncbi.nlm.nih.gov/pubmed/32218893 http://dx.doi.org/10.4240/wjgs.v12.i3.104 |
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