A patient undergoing an intervention for benign esophageal disease may face a rapid progression to esophagectomy. Madenci et al identified risk factors for this situation, which can help to identify a patient who may need to be managed more carefully. The authors are from the University of Michigan.

Patient selection: benign esophageal disease having some form of endoscopic intervention (varices not listed in Figure 1)


Risk factors for rapid progression to esophagectomy:

(1) initial esophageal intervention at age >= 18 years

(2) acquired esophageal disease (vs congenital, see below)

(3) history of fundoplication

(4) several repeat interventions (page 893, conclusion)


Acquired esophageal conditions prompting the intervention:

(1) achalasia

(2) gastroesophageal reflux disease (GERD)

(3) trauma

(4) hiatal hernia

(5) benign tumor


Complications of esophagectomy:

(1) chylothorax

(2) anastomotic leak

(3) reoperation

(4) death


A patient needs to be informed about the risk for esophagectomy prior to an intervention. A patient with risk factors for esophagectomy following an endocscopic intervention may be better off having a definitive procedure performed,

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