LAUSR

Corrosive agents usually induce chemical burn of upper gastro-intestine tract. Most patients could be managed successfully with medical treatment, but damage control surgery (DCS) with esophagectomy and gastrectomy are required when trans-mural necrosis is progressed. Making decision of timing on these radical surgeries is quite difficult in patients without initial peritoneal signs. From Feb. 2007 to Oct. 2016, patients with corrosive injury without indication of emergent DCS were included. All these patients were divided into two groups. The Group 1 receives early laparoscopy within 24 hours after accidents. The other patients receive observations and surgical intervention once organs injuries are progressed. All basic demographic data and clinical outcomes were recorded. Total 65 patients were included. 14 patients receive emergent laparoscopy as Group 1. The other 51 patients receive close observations as Group 2. Two patients in Group 1 convert to DCS and the other patients receive gastrostomy and feeding jejunostomy. 18 patients in Group 2 receive DCS due to progressing peritoneal signs. Rates of esophageal stricture and stomach contracture are higher in Group 2 (8.3% vs. 48.5%, P = 0.014). Early laparoscopy is a good diagnostic tool in corrosive injury patient without obvious peritoneal signs. This method could early detect trans-mural necrosis. In addition to diagnosis, laparoscopy could also perform gastrostomy for adequate drainage that could prevent esophageal and gastric stricture. All authors have declared no conflicts of interest.