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    Evaluation of Different Surgical Techniques to Repair Iatrogenic Esophageal Injury; an Experimental Study
    (Journal Neurological Sciences, 2015) İş, Merih; Pehlivan, Mevlüt; Akyüz, Fevzullah; Çelikoğlu, Erhan; Gökçe, Aysun; Aytekin, Hikmet; Altay, Tamer
    Objective: Esophageal perforation during anterior spine surgery is a rare but serious complication that may lead to death, if not managed properly. Optimal management of these injuries is still debated, which varies from conservative approach to different types of surgical repair. The purpose of this study was to evaluate and compare the healing process following various surgical techniques to repair experimentally induced esophageal injury in rodents. We hypothesized that repair techniques that involve flap rotation along with primary suture was superior to primary suture alone. Material and Methods: Fifty male Sprague-Dawley rats were used for this study. Esophageal injury was induced by a vertical incision through all layers of its wall. Groups were determined according to the repair techniques used, i.e., Group-1 (sham, no injury), Group-2 (primary suture), Group 3 (primary suture plus muscle flap), Group 4 (primary suture omental flap) and Group 5 (untreated). Esophageal segments repaired were obtained fourteen days after the injury/repair surgery for histopathological evaluation. Results: Total histopathological damage scores were highest in Group 5. Lower total scores were obtained in Group 3 than in Group 2 and 5, whereas total scores between Groups 2 and 4, 2 and 5, and 3 and 4 were similar. Infiltration and submucosal/muscular healing scores were higher in Group 2 than in 3. There was no difference in any of the parameters between groups 2 and 4, 2 and 5, and 3 and 4. Conclusions: Primary suture closure reinforced by a muscle flap provides better healing in a rat model of iatrogenic esophageal injury. Primary suture reinforced by omentum, or primary suture alone may be considered as second options for repair.