Conservative management of severe XXXX during acute phase leads to superior long-term nutritional and quality of life (QoL) outcome.

@entity1 @entity353 @entity130
PURPOSE: Best clinical management of severe @entity130 is still a subject of debate. Most surgical teams consider severe @entity130 as an indication for emergency surgery. But, under certain circumstances, conservative management is feasible, avoids the need for gastrectomy, and has a low mortality rate. Postponed reconstructive surgery is usually performed several months after caustic ingestion to restore intestinal continuity or to treat stricture sequelae. This study aimed to investigate long-term nutritional and quality of life (QoL) outcomes after reconstructive surgery for high-grade esophageal and gastric @entity130 . METHODS: Twenty-one @entity1 were assessed for biological and nutritional parameters, physical findings, and quality of life surveys at least 25  months after reconstructive surgery among @entity1 who have required emergency surgery (n   =   10) and @entity1 who did not undergo emergency surgery (n   =   11). RESULTS: After median follow-up of 74  months (after caustic ingestion) and 67  months (after reconstructive surgery), @entity1 who avoided emergency surgery experienced faster oral diet resumption (49 vs. 157  days, p   =   0.004), less @entity353 (0.3 vs. 20  kg, p   =   0.002), greater body fat percentage (22 vs. 18  %, p   =   0.046), better nutritional and physical status (SF12 PCS 51 vs. 43, p   =   0.036), and less trouble eating (EORTC QLQ-OG 25 31 vs. 56, p   =   0.01). CONCLUSIONS: Our study is the first to evaluate long-term nutritional and QoL outcomes, following severe @entity130 . It demonstrates better long-term nutritional outcomes and QoL in @entity1 suitable for initial conservative management. These results support full functional recuperation of spared organs, even severely burned. In the absence of clinical or biological signs necessitating immediate surgery, conservative management should be advocated.
