La rupture spontanée de l'œsophage

Malledant, Yannick; Tanguy, M.; Artus, Majid; Cardin, J.L.; Campion, Jean‐Pierre; Launois, B; Saint-Marc, Cécile

doi:10.1016/s0750-7658(86)80094-6

Cited by 11 publications

(1 citation statement)

References 32 publications

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“…We found a rupture of the running absorbable suture. In our series, despite one suture failure, the absence of postoperative mortality contrasts with that of a previously reported series in which we experienced 45% mortality using other therapeutic methods [24]. Table 1 shows a comparative analysis with other published cases.…”

Section: Discussioncontrasting

confidence: 58%

New Approach to Surgical Management of Early Esophageal Thoracic Perforation: Primary Suture Repair Reinforced with Absorbable Mesh and Fibrin Glue

et al. 1997

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Esophageal perforation is a life-threatening situation and represents a major therapeutic challenge. Results have improved in recent years particularly as a result of progress in antibiotic therapy and the use of total parenteral nutrition. Surgical management retains a predominant role, involving early primary closure and thoracic drainage. We have made an addition to the surgical management by applying an absorbable mesh and fibrin glue to the repaired site. Seven patients (ages 38-79 years) were treated as described. The mean interval from leak to surgery was 28 hours. Six patients had an uneventful postoperative course with a mean hospital stay of 34 days (range 26-45 days). In one case the technique failed and the patient required an exclusion-diversion procedure. All 7 patients recovered without mortality. We believe that this technique provides a real improvement for this precarious esophageal repair.

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Section: Discussioncontrasting

confidence: 58%

New Approach to Surgical Management of Early Esophageal Thoracic Perforation: Primary Suture Repair Reinforced with Absorbable Mesh and Fibrin Glue

et al. 1997

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Improved Survival in Children With Esophageal Perforation

et al. 1996

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Oesophageal perforation: Primary suture repair reinforced with absorbable mesh and fibrin glue

Bardaxoglou

Campion

Landen

et al. 1994

Journal of British Surgery

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Despite major advances in the management of intrathoracic oesophageal perforation, morbidity and mortality rates remain Currently accepted management3 includes early thoracotomy, cleansing of the mediastinum, oesophageal suture and pleural space drainage. Even when performed at an early stage, primary oesophageal suture repair remains precarious, however. Experience of oesophageal primary suture reinforced with absorbable mesh and fibrin glue is reported. Surgical techniqueBetween June 1990 and December 1991, five patients with intrathoracic oesophageal perforation were treated with this technique. The mean age of patients was 59 (range 4379) years. Two iatrogenic perforations resulted from endoscopy (foreign-body extraction, balloon dilatation for achalasia), one from forceful vomiting, one from barotrauma and one from direct injury (chicken bone).Two patients were operated on within 24 h and the other three within 48 h. A transthoracic approach was used. The oesophagus was dissected from its bed in the a m of the perforation. The oesophageal muscular wound was widened to expose the whole length of the mucosal rupture. Healthy mucosa was sutured with 5/0 silk or polydioxanone. In the patient with achalasia an absorbable polyglactin mesh was shaped to fit the sue of the muscular edges. Biological glue (Tissucol; Immuno, Brussels, Belgium) was applied over the prosthetic flap and around the neighbouring oesophagus (Fig. la). Thereafter a Heller procedure was performed. In the other four patients the muscle layer was approximated, an absorbable mesh was wrapped and sutured around half the circumference of the oesophagus (to cover the repair) and the glue was applied thereafter (Fig. Ib). The chest was drained. A feeding jejunostomy was created and a nasogastric suction tube placed to minimize gastro-oesophageal reflux. Antibiotics were given in each case. Oral feeding was started once radiological studies had confirmed oesophageal healing.

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La rupture spontanée de l'œsophage

Cited by 11 publications

References 32 publications

New Approach to Surgical Management of Early Esophageal Thoracic Perforation: Primary Suture Repair Reinforced with Absorbable Mesh and Fibrin Glue

New Approach to Surgical Management of Early Esophageal Thoracic Perforation: Primary Suture Repair Reinforced with Absorbable Mesh and Fibrin Glue

Improved Survival in Children With Esophageal Perforation

Oesophageal perforation: Primary suture repair reinforced with absorbable mesh and fibrin glue

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