Colombia Médica | 1/9 Jun 30 - 2021 http://doi.org/10.25100/cm.v52i2.4806 REVIEW Primary repair: damage control surgery in esophageal trauma El reparo primario: el control de daños en el trauma de esófago Mauricio Millán, 1,2 Michael W. Parra, 3 Boris Sanchez-Restrepo, 4 Yaset Caicedo,⁵ Carlos Serna,⁴ Adolfo González-Hadad, 4,6,7 Luis Fernando Pino, 4,7 Mario Alain Herrera, 4,7 Fabian Hernández, 4,7 Fernando Rodríguez-Holguín, 5 Alexander Salcedo, 2,4,7,8 José Julián Serna, 2,4,7,8 Alberto García, 2,4,8 Carlos A. Ordoñez 2,4,8 ordonezcarlosa@gmail.com, carlos.ordonez@fvl.org.co 1 Fundación Valle del Lili, Department of Surgery, Division of Transplant Surgery, Cali, Colombia, 2 Universidad Icesi, Cali, Colombia. , 3 Broward General Level I Trauma Center, Department of Trauma Critical Care, Fort Lauderdale, FL - USA, 4 Universidad del Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery, Division of Trauma and Acute Care Surgery, Cali, Colombia., 5 Fundación Valle del Lili, Centro de Investigaciones Clínicas (CIC), Cali, Colombia 6 Centro Médico Imbanaco, Cali, Colombia. , 7 Hospital Universitario del Valle, Department of Surgery, Division of Trauma and Acute Care Surgery, Cali, Colombia., 8 Fundación Valle del Lili, Department of Surgery, Division of Trauma and Acute Care Surgery, Cali, Colombia., Abstract Esophageal trauma is a rare but life-threatening event associated with high morbidity and mortality. An inadvertent esophageal perforation can rapidly contaminate the neck, mediastinum, pleural space, or abdominal cavity, resulting in sepsis or septic shock. Higher complications and mortality rates are commonly associated with adjacent organ injuries and/or delays in diagnosis or defnitive management. This article aims to delineate the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia, on the surgical management of esophageal trauma following damage control principles. Esophageal injuries should always be suspected in thoracoabdominal or cervical trauma when the trajectory or mechanism suggests so. Hemodynamically stable patients should be radiologically evaluated before a surgical correction, ideally with computed tomography of the neck, chest, and abdomen. While hemodynamically unstable patients should be immediately transferred to the operating room for direct surgical control. A primary repair is the surgical management of choice in all esophageal injuries, along with endoscopic nasogastric tube placement and immediate postoperative care in the intensive care unit. We propose an easy-to-follow surgical management algorithm that sticks to the philosophy of "Less is Better" by avoiding esophagostomas. Citation: Millán M, Parra MW, Sánchez-Restrepo B, Caicedo Y, Serna C, Gonzálex-Hadad, Pino LF, Herrera MA, Hernández F, Rodríguez-Holguín F, Salceso A, Serna JJ,García A, Ordoñez CA. Primary repair: damage control surgery in esophageal trauma. Colomb Méd (Cali), 2021; 52(2):e4094806 http://doi. org/10.25100/cm.v52i2.4806 Received: 31 Mar 2021 Revised: 25 May 2021 Accepted : 25 Jun 2021 Published: 30 Jun 2021 Keywords: Esophageal stenosis, advanced trauma life support care, laparotomy, fundoplication, negative-pressure wound therapy, deglutition disorders, mediastinal emphysema, thora- cotomy, tracheoesophageal fstula, esophagus. Palabras clave: Estenosis esofágica, cuidados de soporte vital avanzado para trauma- tismos, laparotomía, funduplicatura, tratamiento de heridas con presión negativa, trastornos de la deglución, enfsema mediastínico, toracotomía, fístula traqueoesofágica, esófago. OPEN ACCESS