Protective effect of early placement of nasogastric tube with solid dilator on tissue damage and stricture formation after caustic esophageal burns in rabbits

Background: The ingestion of caustic substances remains an important public health issue worldwide. Children represent 80% of the ingestion injury population globally. Accidental alkaline material accounts for most caustic ingestions. There is no conclusive evidence of tissue damage and stricture protection of a nasogastric-tube with a solid dilator in the literature, therefore it was hypothesized that early intraesophageal tube placement does not cause additional histopathologic damage and prevents strictures. Methods: An exploratory study on experimental caustic esophageal burns in a rabbit model was designed. In the treated group a silicone tube was placed immediately after causing the burns, while the untreated group followed the natural course of the burn. On the twenty-second day, an esophagectomy was performed on all animals for microscopic (Histopathologic Damage Score and Stenosis Index) and macroscopic analysis. Results: Forty animals were randomly divided into two groups. The Histopathologic Damage Score was 3.7 +/- 1.1 in the treated group versus 3.9 +/- 1.2 in the untreated group (p = .9690). The Stenosis Index was 0.6 +/- 0.1 in treated rabbits versus 2.3 +/- 0.2 in untreated (p < .0001). Conclusion: The early placement of an intraesophageal tube with solid dilator prevents stenosis formation and does not produce greater tissue damage. (C) 2015 Elsevier Inc. All rights reserved.