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

Abstract

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.