PURPOSE:To evaluate the efficacy of surgical treatment for esophageal perforation. METHODS:A systematic review of the literature was performed. We conducted a search strategy in the main electronic databases such as PubMed, Embase and Lilacs to identify all case series. RESULTS:Thirty three case series met the inclusion criteria with a total of 1417 participants. The predominant etiology was iatrogenic (54.2%) followed by spontaneous cause (20.4%) and in 66.1% the localization was thoracic. In 65.4% and 33.4% surgical and conservative therapy, respectively, was considered the first choice. There was a statistically significance different with regards mortality rate favoring the surgical group (16.3%) versus conservative treatment (21.2%) (p<0.05). CONCLUSION:Surgical treatment was more effective and safe than conservative treatment concerning mortality rates, although the possibility of bias due to clinical and methodological heterogeneity among the included studies and the level of evidence that cannot be ruled out.

. Mentor, designed the protocol and critical review. ABSTRACT PURPOSE:To study the effect of alcoholism on intestinal healing and postoperative complications in rats. METHODS:One hundred and sixty rats were divided into two groups: control and treated. The control group received water and the treated group 30% ethanol. After 180 days, colotomy with anastomosis were performed. After, the groups were divided into four subgroups: 20 rats for study at the following moments: 4 th , 7 th , 14 th and 21 st postoperative. The analyzed parameters were: weight gain, breaking strength, tissue hydroxyproline, postoperative complications and histopathological study. RESULTS:Weight gain was greater in the control group (p<0.05). When all the subgroups were clustered, breaking strength was significantly greater in the control (p<0.05). Histopathology and hydroxyproline dosage did not show differences. There were five surgical site infections in the treated group while the control group showed two (p>0.05). Nine fistulas occurred in the treated group whereas the control group two (p<0.05). There were three deaths in the control group and seven in the treated group (p>0.05). CONCLUSIONS:Treated group undergo a malnutrition process that is revealed by lower weight gain. Impaired intestinal healing as indicated by smaller breaking strength. There were a larger number of postoperative complications in the treated animals.Key words: Wound Healing. Alcoholism. Ethanol. Tensile Strenght. Hydroxyproline. Rats. RESUMO OBJETIVO:Estudar o efeito do alcoolismo no processo de cicatrização intestinal e suas complicações pós-operatórias em ratos. MÉTODOS:Cento e sessenta ratos foram divididos em dois grupos: tratado e controle. O controle recebeu água, enquanto o tratado etanol a 30%. Após 180 dias foram realizadas colotomia, seguida de anastomose. Após os animais foram divididos em quatro subgrupos de 20 ratos para estudo nos seguintes momentos: 4º, 7º, 14º e 21º pós-operatório. Os parâmetros analisados foram: ganho de peso, força de ruptura, hidroxiprolina tecidual, complicações pós-operatórias e estudo histopatológico. RESULTADOS:O ganho de peso foi superior no grupo controle (p<0,05). Após agrupamento dos momentos a força de ruptura foi superior no controle (p<0,05). Não houve diferença quanto à histopatologia e hidroxiprolina. Houve cinco infecções de incisão no grupo tratado, enquanto no controle ocorreram duas (p>0,05). Houve nove fístulas no grupo tratado, enquanto no controle duas (p<0,05).Ocorreram sete mortes no grupo tratado e apenas três no controle (p>0,05). Intestinal healing in rats submitted to ethanol ingestionActa Cirúrgica Brasileira -Vol. 27 (3) 2012 -237 CONCLUSÕES:No grupo tratado ocorreu um processo de subnutrição evidenciado pelo menor ganho de peso. Piora na cicatrização intestinal, indicada pela menor força de ruptura. Ocorreu um maior número de complicações pós-operatórias no grupo tratado.Descritores: Cicatrização. Alcoolismo. Etanol. Resistência à Tração. Hidroxiprolina. Ratos.

Patients submitted to LNF surgery have decreased cardiorespiratory function in the early postoperative period; however, they soon return to preoperative conditions.