Surgical Treatment of Esophageal Perforation.
- Author:
Han Yong KIM
1
;
Jae Hong PARK
;
Chang Seck CHEI
;
Dae Hwan KIM
;
Sang Won HWANG
;
Byung Ha YOO
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Korea. hyk6022@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Esophageal perforation;
Boerhaave's syndrome
- MeSH:
Diagnosis;
Drainage;
Esophageal Perforation*;
Esophagectomy;
Esophagus;
Female;
Foreign Bodies;
Gastrostomy;
Hospital Mortality;
Humans;
Male;
Mortality;
Retrospective Studies;
Rupture, Spontaneous
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2006;39(3):214-219
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. MATERIAL AND METHOD: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours. Esophageal repair was performed in 21 (75%) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. RESULT: Hospital mortality was 18% and iatrogenic was increase the mortality rate (p <0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. CONCLUSION: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful managenent of patients.
